Provider Demographics
NPI:1477504785
Name:BOWES, HARRISON N JR
Entity Type:Individual
Prefix:
First Name:HARRISON
Middle Name:N
Last Name:BOWES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 NORTH MAIN
Mailing Address - Street 2:#721
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205
Mailing Address - Country:US
Mailing Address - Phone:210-223-4273
Mailing Address - Fax:210-212-6870
Practice Address - Street 1:730 N MAIN
Practice Address - Street 2:#721
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205
Practice Address - Country:US
Practice Address - Phone:210-223-4273
Practice Address - Fax:210-212-6870
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5390207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110746803Medicaid
B51688Medicare UPIN