Provider Demographics
NPI:1154658045
Name:BOWERS, DARRYL (RPH)
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:
Last Name:BOWERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 BAY AREA BLVD STE B230
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2505
Mailing Address - Country:US
Mailing Address - Phone:346-230-7984
Mailing Address - Fax:281-747-1554
Practice Address - Street 1:1300 BAY AREA BLVD STE B230
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2505
Practice Address - Country:US
Practice Address - Phone:346-230-7984
Practice Address - Fax:281-747-1554
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist