Provider Demographics
NPI:1295735140
Name:BOWMAN, RICHARD THOMSON (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:THOMSON
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 1:4001 W 15TH ST STE 335
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5859
Mailing Address - Country:US
Mailing Address - Phone:972-867-5300
Mailing Address - Fax:972-867-5301
Practice Address - Street 1:4001 W 15TH ST STE 335
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5859
Practice Address - Country:US
Practice Address - Phone:972-867-5300
Practice Address - Fax:972-867-5301
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2020-05-26
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
TXH5844174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B3629Medicare ID - Type Unspecified
TXB77212Medicare UPIN