Provider Demographics
NPI:1316536840
Name:BOWIE, KERI (RBT)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:BOWIE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 OLD CHOCOLATE BAYOU RD STE A
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8996
Mailing Address - Country:US
Mailing Address - Phone:832-632-2177
Mailing Address - Fax:281-724-1257
Practice Address - Street 1:2913 OLD CHOCOLATE BAYOU RD STE A
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8996
Practice Address - Country:US
Practice Address - Phone:832-632-2177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-21-150830106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician