Provider Demographics
NPI:1578269452
Name:BOWDEN, CARLTON EUGENE II
Entity Type:Individual
Prefix:
First Name:CARLTON
Middle Name:EUGENE
Last Name:BOWDEN
Suffix:II
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 1:8908 PARK ST
Mailing Address - Street 2:
Mailing Address - City:NEEDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77461-7862
Mailing Address - Country:US
Mailing Address - Phone:346-272-9012
Mailing Address - Fax:
Practice Address - Street 1:8908 PARK ST
Practice Address - Street 2:
Practice Address - City:NEEDVILLE
Practice Address - State:TX
Practice Address - Zip Code:77461-7862
Practice Address - Country:US
Practice Address - Phone:346-272-9012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251B00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No171M00000XOther Service ProvidersCase Manager/Care Coordinator