MEDICARE: ALLISSA MARY BOWMAN PA-C

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	363A00000X	Physician Assistant	PA17510	TX
2	363A00000X	Physician Assistant	4853	OK

General Provider Information

NPI Number	:	1235873803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISSA MARY BOWMAN PA-C

Provider Business Mailing Address
First Line	:	3711 BISHOP HILL DR
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-2002
Country	:	US
Telephone Number	:	608-235-9601
Fax Number	:

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD STOP 7200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-5822
Country	:	US
Telephone Number	:	214-648-3111
Fax Number	:

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

Provider Enumeration Date	:	04/20/2022
Last Update Date	:	01/21/2026

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Directions to “ ALLISSA MARY BOWMAN PA-C” Practice Location

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