Provider Demographics
NPI:1518992155
Name:THOMAS E. BOWSER MD PLLC
Entity Type:Organization
Organization Name:THOMAS E. BOWSER MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOWSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-637-8444
Mailing Address - Street 1:4105 BRIARGATE PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3482
Mailing Address - Country:US
Mailing Address - Phone:719-637-8444
Mailing Address - Fax:
Practice Address - Street 1:4105 BRIARGATE PKWY STE 105
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3482
Practice Address - Country:US
Practice Address - Phone:719-637-8444
Practice Address - Fax:719-638-8286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO59127015Medicaid