MICAH CHRISTIAN BOWMAN (NPI# 1013539998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013539998 |
| Entity Type | Individual |
| Full Name | MICAH CHRISTIAN BOWMAN |
| Credential | PA-C |
| Practice Address |
2419 W Southlake Blvd Ste 100 Southlake TX 76092-1506 |
| Mailing Address |
9001 Zubia Ln Fort Worth TX 76131-3415 |
| Practice Telephone | 4695356842 |
| Mailing Telephone | 2082522045 |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2419 W SOUTHLAKE BLVD STE 100 |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092-1506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942564778 | Andrew Paul Freese | Orthopaedic Surgery | 2419 W Southlake Blvd Ste 100, Southlake, TX 76092 | 2012-06-26 |
| 1205464138 | Niranjan Kc | Physician Assistant | 2419 W Southlake Blvd Ste 100, Southlake, TX 76092-1506 | 2020-03-27 |
| 1285192484 | Tracee Smith | Physical Therapist | 2419 W Southlake Blvd Ste 100, Southlake, TX 76092-1506 | 2019-03-06 |
| 1518476407 | Doctx3 Pllc | Clinic/Center | 2419 W Southlake Blvd Ste 100, Southlake, TX 76092-6718 | 2017-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1952805848 | Nathan Annop Mahanirananda | Physician Assistant | 2813 W Southlake Blvd Ste 100, Southlake, TX 76092-6832 | 2018-03-23 |
| 1073060562 | Elizabeth Williams | Physician Assistant | 560 N Kimball Ave, Ste 100, Southlake, TX 76092-6624 | 2016-09-01 |
| 1336531805 | Evoni Noel | Physician Assistant | 630 N Kimball Ave Ste 100, Southlake, TX 76092 | 2015-02-20 |
| 1578815304 | Gena Marie Ettinger | Physician Assistant | 300s. Nolen Dr., Suite 100, Southlake, TX 76092-8057 | 2012-10-03 |
| 1457673691 | Hina Mazharuddin | Physician Assistant | 1125 David Blvd., Ste. 100, Southlake, TX 76092 | 2010-02-15 |
| 1134373491 | Lisa Tshuma | Physician Assistant | 321 W Southlake Blvd, Suite #180, Southlake, TX 76092-6188 | 2008-11-12 |
| 1437294170 | Brooke A Hodnick | Physician Assistant | 300 S Nolen Dr Ste 100, Southlake, TX 76092-8057 | 2007-02-20 |
| 1205464138 | Niranjan Kc | Physician Assistant | 2419 W Southlake Blvd Ste 100, Southlake, TX 76092-1506 | 2020-03-27 |
| Find all providers in SOUTHLAKE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.