Mark Thomas Bowen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

932-143T Issued in LA

Practice address

Alexandria Vahcs
2495 Shreveport Hwy
Pineville, LA 71360-4044

Phone

(318) 473-0010

NPI assigned

Jan 30, 2006

Last updated

Sep 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1598736209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ALEXANDRIA VAHCS",
            "address_2": "2495 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-473-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ALEXANDRIA VAHCS",
            "address_2": "2495 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-473-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "932-143T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1370886",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Williams Bordelon, MSW, LCSW, BACS
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• Kenneth W Boudreaux, R.PH.
• Angela C. Bovain, PHARMD
• Elizabeth Highland Bowles, M.D.
• Jacob Wren Boykin, RPH
• Erika Renee Boykins, L.C.S.W.
• Kayla Brabaw, PT, DPT
• Stepehen Brandow, M.DIV.

• Optometrist in Pineville, LA
• Providers in Pineville, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.