Provider Demographics
NPI:1518129592
Name:BOWEN, MEGAN MARY (DO)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARY
Last Name:BOWEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2529
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77497-2529
Mailing Address - Country:US
Mailing Address - Phone:713-772-1200
Mailing Address - Fax:713-255-6315
Practice Address - Street 1:23920 KATY FWY STE 410
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0881
Practice Address - Country:US
Practice Address - Phone:713-772-1200
Practice Address - Fax:281-693-3522
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-1291208600000X, 208D00000X
TXR9044208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN