Provider Demographics
NPI:1245854595
Name:BOWERS, LADORIS BEATRICE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:LADORIS
Middle Name:BEATRICE
Last Name:BOWERS
Suffix:
Gender:
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 ROCK PRAIRIE RD STE 3000
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-5989
Mailing Address - Country:US
Mailing Address - Phone:979-774-3232
Mailing Address - Fax:979-680-4895
Practice Address - Street 1:1602 ROCK PRAIRIE RD STE 3000
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5989
Practice Address - Country:US
Practice Address - Phone:979-774-3232
Practice Address - Fax:979-680-4895
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP1444455363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1245854595Medicaid
TX8SY322OtherBCBS PROVIDER ID