MEDICARE: MR. TY JASON BOWRING DPT

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	2251X0800X	Orthopedic Physical Therapist		TX

General Provider Information

NPI Number	:	1457219172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TY JASON BOWRING DPT

Provider Business Mailing Address
First Line	:	650 LEORA LN APT 1533
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75056-3973
Country	:	US
Telephone Number	:	469-632-7282
Fax Number	:

Provider Business Practice Location Address
First Line	:	7217 TELECOM PKWY FL 2
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-2202
Country	:	US
Telephone Number	:	972-495-6986
Fax Number	:	972-895-8576

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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