Provider Demographics
NPI:1366559338
Name:BOWLES, AMY O'BRIEN (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:O'BRIEN
Last Name:BOWLES
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:BRAIN INJURY REHABILITATION SERVICE MCHE-DOR-BI
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-8693
Mailing Address - Fax:210-916-6679
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:BRAIN INJURY REHABILITATION SERVICE MCHE-DOR-BI
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-8693
Practice Address - Fax:210-916-6679
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-11-07
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Provider Licenses
StateLicense IDTaxonomies
TXL5994208100000X, 2081P0301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159338601Medicaid