Provider Demographics
NPI:1184636078
Name:BOWMAN, WILLIAM P (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:BOWMAN
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:PO BOX 99371
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0371
Mailing Address - Country:US
Mailing Address - Phone:682-885-4434
Mailing Address - Fax:682-885-3936
Practice Address - Street 1:1500 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2710
Practice Address - Country:US
Practice Address - Phone:682-885-4007
Practice Address - Fax:682-885-3914
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG40872080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX40172OtherFIRSTHEALTH PIN
TX00U87ZOtherBCBSTX GRP PIN
TX134732011Medicaid
TX134732012OtherCSHCN
TX140442852OtherMEDICAID GROUP
TX2599093OtherCIGNA PIN
TX60438OtherUHC PIN
TX8L21944OtherMEDICARE PIN LOCALITY 99
TX10028686OtherAMERIGROUP PIN
TX134732014OtherCSHCN LOCALITY 99
TX150220509OtherCSHCN LOCALITY 99
TX137345810OtherCSHCN GROUP
TX4019271OtherAETNA PIN
TX00U87ZOtherMEDICARE GROUP
TX108985100OtherFIRSTCARE PIN
TX134732013OtherMEDICAID LOCALITY 99
TX150220508OtherMEDICAID GROUP LOCALITY 99
TX00257TOtherMEDICARE GROUP LOCALITY 99
TX139314OtherPHCS PIN
TX100707OtherSUPERIOR PIN
TX81X460OtherBCBSTX IND PIN
TX40172OtherFIRSTHEALTH PIN
TX4019271OtherAETNA PIN