Provider Demographics
NPI:1053394627
Name:DOWD, PHILLIP E (MD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:E
Last Name:DOWD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5500 KELL BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-1612
Mailing Address - Country:US
Mailing Address - Phone:940-689-8765
Mailing Address - Fax:940-689-8769
Practice Address - Street 1:5500 KELL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-1612
Practice Address - Country:US
Practice Address - Phone:940-689-8765
Practice Address - Fax:940-689-8769
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH6172208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0243510001OtherMEDICARE DME, PALMETTO
TX815317OtherBLUE CROSS & BLUE SHIELD
TX815317OtherBLUE CROSS & BLUE SHIELD