Basic Information
Provider Information
NPI: 1548467905
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOWMAN
FirstName: MAY
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4231 WESTLAKE DR
Address2: #61
City: AUSTIN
State: TX
PostalCode: 78746
CountryCode: US
TelephoneNumber: 5127457161
FaxNumber:  
Practice Location
Address1: 2913 WILLIAMS DR
Address2: SUITE 320
City: GEORGETOWN
State: TX
PostalCode: 786282740
CountryCode: US
TelephoneNumber: 5128680505
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/29/2007
LastUpdateDate: 09/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0002XH9809TXY Allopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine

No ID Information.


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