Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | K9770 | TX |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | K9770 | TX |
NPI | 1699858282 |
---|---|
Provider Name | Dr. Mary Talley Bowden |
First Address | Houston, TX 77008-1440 |
Second Address | Houston, TX 77098-3941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 29/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8J9960 | BLUE CROSS BLUE SHIELD (01) | TX |
H87955 | (02) |