Provider Demographics
NPI:1396026241
Name:BOWLIN, TRISSI (BA, HIS)
Entity Type:Individual
Prefix:
First Name:TRISSI
Middle Name:
Last Name:BOWLIN
Suffix:
Gender:F
Credentials:BA, HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SHUMAN BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8123
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:630-303-5385
Practice Address - Street 1:6809 W NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-4202
Practice Address - Country:US
Practice Address - Phone:214-691-5466
Practice Address - Fax:214-691-7250
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80476237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist