Provider Demographics
NPI:1053526160
Name:RAY L. BOWMAN, PH.D., P.A.
Entity type:Organization
Organization Name:RAY L. BOWMAN, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-345-1234
Mailing Address - Street 1:6740 CROSSWINDS DR N
Mailing Address - Street 2:SUITE H
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8606
Mailing Address - Country:US
Mailing Address - Phone:727-345-1234
Mailing Address - Fax:727-344-0000
Practice Address - Street 1:6740 CROSSWINDS DR N
Practice Address - Street 2:SUITE H
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8606
Practice Address - Country:US
Practice Address - Phone:727-345-1234
Practice Address - Fax:727-344-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty