Provider Demographics
NPI:1649612268
Name:BOWMAN-GARRETT, JACQUELYN (DC)
Entity type:Individual
Prefix:DR
First Name:JACQUELYN
Middle Name:
Last Name:BOWMAN-GARRETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 CHISHOLM DR
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-3558
Mailing Address - Country:US
Mailing Address - Phone:830-431-4097
Mailing Address - Fax:
Practice Address - Street 1:117 W HIGHLAND DR STE 101
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2659
Practice Address - Country:US
Practice Address - Phone:830-431-4097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor