Provider Demographics
NPI:1003025024
Name:FREDA J. BOWMAN, M.D, P.A.
Entity Type:Organization
Organization Name:FREDA J. BOWMAN, M.D, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-316-1188
Mailing Address - Street 1:450 MEDICAL CENTER BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4230
Mailing Address - Country:US
Mailing Address - Phone:281-316-1188
Mailing Address - Fax:281-338-0418
Practice Address - Street 1:450 MEDICAL CENTER BLVD STE 310
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4230
Practice Address - Country:US
Practice Address - Phone:281-316-1188
Practice Address - Fax:281-338-0418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4378207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX106078203Medicaid
TX106078204Medicaid
TX8B7092Medicare ID - Type Unspecified
TX106078204Medicaid
TXF66119Medicare UPIN