Healthcare Provider Details

I. General information

NPI: 1336144674
Provider Name (Legal Business Name): WILLIAM T BOWERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 W INTERSTATE 20 SUITE 212
ARLINGTON TX
76017-5870
US

IV. Provider business mailing address

811 W INTERSTATE 20 SUITE 212
ARLINGTON TX
76017-5870
US

V. Phone/Fax

Practice location:
  • Phone: 817-275-3309
  • Fax: 817-265-0071
Mailing address:
  • Phone: 817-275-3309
  • Fax: 817-265-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0061
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: