Individual
DR. PHILLIP BOWES BANDEL
Active
Individual
DR. PHILLIP BOWES BANDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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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