Provider Demographics
NPI:1013950567
Name:BOWSER, ANDREW N (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:N
Last Name:BOWSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W WINDCREST ST STE 130
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4478
Mailing Address - Country:US
Mailing Address - Phone:830-997-7138
Mailing Address - Fax:830-997-8678
Practice Address - Street 1:205 W WINDCREST ST STE 130
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4478
Practice Address - Country:US
Practice Address - Phone:830-997-7138
Practice Address - Fax:830-997-8678
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME827832086S0129X
OH35.0722932086S0129X
TXM91702086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BK510OtherBCBS
TX1947038-01Medicaid
TX8F8668OtherMEDICARE INDIVIDUAL PTAN