Provider Demographics
NPI:1972709889
Name:BOWIE, RUFUS DWAYNE III
Entity Type:Individual
Prefix:MR
First Name:RUFUS
Middle Name:DWAYNE
Last Name:BOWIE
Suffix:III
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:PO BOX 7755
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75607-7755
Mailing Address - Country:US
Mailing Address - Phone:903-753-1771
Mailing Address - Fax:903-753-1771
Practice Address - Street 1:2323 ARMOND DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75602-3625
Practice Address - Country:US
Practice Address - Phone:903-753-1771
Practice Address - Fax:903-753-1771
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist