MEDICARE: JASON K BOWMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PH0002X	Hospice and Palliative Medicine (Emergency Medicine) Physician	267079	MA
2	207PH0002X	Hospice and Palliative Medicine (Emergency Medicine) Physician	U8692	TX
3	207P00000X	Emergency Medicine Physician	U8692	TX
4	207P00000X	Emergency Medicine Physician	267079	MA

General Provider Information

NPI Number	:	1124474010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON K BOWMAN MD

Provider Business Mailing Address
First Line	:	75 FRANCIS ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-6106
Country	:	US
Telephone Number	:	617-732-5640
Fax Number	:

Provider Business Practice Location Address
First Line	:	1504 TAUB LOOP
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1608
Country	:	US
Telephone Number	:	713-873-8890
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2016
Last Update Date	:	04/19/2024

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