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General NPI Number Information
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NPI Number | 1871006510
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Entity Type | Individual
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Provider Name | ANDREA LAYNE BOWDEN PA-C, MPAS
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Gender | Female
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 2120 ASHLAND ST
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City | HOUSTON
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State | TX
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Zip | 77008-2418
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Country | US
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Telephone | 832-981-7310
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Fax |
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Provider Business Mailing Address
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Address Line | 555 W 19TH ST APT 447
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City | HOUSTON
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State | TX
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Zip | 77008-4194
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Country | US
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Telephone | 512-680-2234
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Fax |
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | PA11583
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | PA11583
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License Number State | TX
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