MEDICARE: DR. BRUCE S. BOWERS M.D.

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	207R00000X	Internal Medicine Physician	M2908	TX
2	207RC0000X	Cardiovascular Disease Physician	M2908	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619979622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE S. BOWERS M.D.

Provider Business Mailing Address
First Line	:	7777 FOREST LN
Second Line	:	SUITE C339
City	:	DALLAS
State	:	TX
Zip	:	75230-2571
Country	:	US
Telephone Number	:	972-566-8855
Fax Number	:	972-566-7509

Provider Business Practice Location Address
First Line	:	7777 FOREST LN
Second Line	:	SUITE C339
City	:	DALLAS
State	:	TX
Zip	:	75230-2571
Country	:	US
Telephone Number	:	972-566-8855
Fax Number	:	972-566-7509

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	02/10/2022

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