Individual
DR. PHILLIP BOWES BANDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
911 LAMAR AVE, PARIS, TX 75460-4681
(903) 785-7546
(903) 785-8445
Mailing address
911 LAMAR AVE, PARIS, TX 75460-4681
(903) 785-7546
(903) 785-8445
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
F2165
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00794K
MEDICARE
TX
05
—
081161401
—
TX
01
—
100082700A
OK MEDICAID
OK
01
—
826072054
RR MEDICARE
TX
Enumeration date
05/11/2006
Last updated
05/16/2008
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