Provider Demographics
NPI:1861442030
Name:BOWELL, DUNCAN G (MD)
Entity Type:Individual
Prefix:DR
First Name:DUNCAN
Middle Name:G
Last Name:BOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1091 N MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:VIDOR
Mailing Address - State:TX
Mailing Address - Zip Code:77662-4360
Mailing Address - Country:US
Mailing Address - Phone:409-769-0237
Mailing Address - Fax:409-769-0254
Practice Address - Street 1:1091 N MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-4359
Practice Address - Country:US
Practice Address - Phone:409-769-0237
Practice Address - Fax:409-769-0254
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9547207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB21428Medicare UPIN
TX611640Medicare PIN