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General NPI Number Information
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NPI Number | 1336299098
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Entity Type | Individual
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Provider Name | MICHAEL LAWRENCE BOWEN D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 545 E REDD RD SUITE C-2
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City | EL PASO
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State | TX
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Zip | 79912-1293
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Country | US
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Telephone | 915-298-1008
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Fax | 915-298-1009
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Provider Business Mailing Address
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Address Line | 545 E REDD RD SUITE C2
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City | EL PASO
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State | TX
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Zip | 79912-1293
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Country | US
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Telephone | 915-298-1008
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Fax | 915-298-1009
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | M6539
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License Number State | TX
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