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General NPI Number Information
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NPI Number | 1063777985
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Entity Type | Individual
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Provider Name | HAROLD DEAN BOWKER III MD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2012
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 16633 DALLAS PKWY STE 100
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City | ADDISON
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State | TX
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Zip | 75001-6894
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Country | US
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Telephone | 919-604-2185
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Fax | 214-853-5608
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Provider Business Mailing Address
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Address Line | 4445 MILL RUN RD
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City | DALLAS
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State | TX
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Zip | 75244-6430
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Country | US
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Telephone | 919-604-2185
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Fax | 214-853-5605
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 4301112110
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R73514
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License Number State | AZ
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