MEDICARE: KATIE BOWMAN

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	183700000X	Pharmacy Technician

General Provider Information

NPI Number	:	1780358226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE BOWMAN

Provider Business Mailing Address
First Line	:	10161 W GRAND PKWY S
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8643
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10161 W GRAND PKWY S
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8643
Country	:	US
Telephone Number	:	832-612-5892
Fax Number	:

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

Provider Enumeration Date	:	08/08/2021
Last Update Date	:	08/08/2021

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Directions to “ KATIE BOWMAN ” Practice Location

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