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General NPI Number Information
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NPI Number | 1295325611
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Entity Type | Organization
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Legal Business Name | MIDSOUTH HOMECARE PLLC
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 5904 SUMMERFIELD DR
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City | TEXARKANA
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State | TX
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Zip | 75503-4306
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Country | US
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Telephone | 430-278-0005
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Fax | 430-278-0006
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Provider Business Mailing Address
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Address Line | 5904 SUMMERFIELD DR
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City | TEXARKANA
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State | TX
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Zip | 75503-4306
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Country | US
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Telephone | 430-278-0005
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Fax | 430-278-0006
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VERNON DEAN BOWMAN
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Credential | MD
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Telephone | 430-200-4350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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