Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 65248 | TX |
NPI | 1003396375 |
---|---|
Provider Name | William Connor Bowie |
First Address | Austin, TX 78705-5537 |
Second Address | Austin, TX 78705-5537 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2018 |
Last Update Date | 16/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
65248 | TEXAS DEPARTMENT OF STATE HEALTH SERVICES (01) | TX |