Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | J3053 | TX |
N | 207VX0000X | Obstetrician | J3053 | TX |
NPI | 1366445066 |
---|---|
Provider Name | Dr. Darrell Lynn Bowyer |
First Address | Burleson, TX 76028-7035 |
Second Address | Burleson, TX 76028-7035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2005 |
Last Update Date | 21/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
099136601 | (05) | TX |
1366445066 | (05) | TX |
752491299 | TAX ID.# (01) | TX |
F62180 | (02) | TX |