Provider Demographics
NPI:1346428505
Name:BOWIE, FINA (ANP, GNP)
Entity Type:Individual
Prefix:
First Name:FINA
Middle Name:
Last Name:BOWIE
Suffix:
Gender:F
Credentials:ANP, GNP
Other - Prefix:
Other - First Name:FINA
Other - Middle Name:
Other - Last Name:MODEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1510 N HAMPTON RD STE 260
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-8310
Mailing Address - Country:US
Mailing Address - Phone:817-909-6874
Mailing Address - Fax:817-303-3373
Practice Address - Street 1:1510 N HAMPTON RD
Practice Address - Street 2:SUITE 260
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-8300
Practice Address - Country:US
Practice Address - Phone:817-909-6874
Practice Address - Fax:817-303-3373
Is Sole Proprietor?:No
Enumeration Date:2008-02-09
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX692038363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology