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NPI Code Detail

MEDICARE: CRAIG BOWEN PT, DPT

MEDICARE: CRAIG BOWEN PT, DPT
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
1225100000XPhysical Therapist1300060TX

General Provider Information

NPI Number : 1720596927
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG BOWEN PT, DPT
Provider Business Mailing Address
First Line : 8627 CINNAMON CREEK DR STE 402
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78240-1482
Country : US
Telephone Number : 210-519-0191
Fax Number : 210-888-1279
Provider Business Practice Location Address
First Line : 12952 BANDERA RD STE 107
Second Line :
City : HELOTES
State : TX
Zip : 78023-4733
Country : US
Telephone Number : 210-372-9600
Fax Number : 210-392-9923
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2018
Last Update Date : 11/06/2020

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