Organization
LAURENCE ROBERT BOWER III
Active
Other names
CENTRAL TEXAS OPEN MRI
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA DELEON (ADMINISTRATOR)
(830) 632-7562
Entity
Organization
Contact information
Practice address
19A GRUENE PARK DRIVE, NEW BRAUNFELS, TX 78130
(830) 606-1200
(830) 606-1276
Mailing address
19A GRUENE PARK DR, NEW BRAUNFELS, TX 78130-2484
(830) 632-7562
(830) 632-6793
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0047RG
BLUECROSS BLUESHIELD
TX
05
—
364400701
—
TX
Enumeration date
09/17/2006
Last updated
08/23/2018
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