MEDICARE: BOWMAN MEDICAL GROUP, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D 3161	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1861491268	OTHER		NPI

General Provider Information

NPI Number	:	1295910628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOWMAN MEDICAL GROUP, PLLC

Provider Business Mailing Address
First Line	:	1930 EL DORADO BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-3621
Country	:	US
Telephone Number	:	281-488-0082
Fax Number	:	281-488-4761

Provider Business Practice Location Address
First Line	:	1930 EL DORADO BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-3621
Country	:	US
Telephone Number	:	281-488-0082
Fax Number	:	281-488-4761

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALBERT B. BOWMAN
Credential	:	M.D.
Telephone Number	:	281-488-0082

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	01/03/2008

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