Individual provider Active NPI

Kyra Lane Bowden

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1912600412
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
STUDENT
Practice address
3900 Junius St Ste 705
Dallas, TX 75246-1627
Phone
(972) 817-7450
NPI assigned
Mar 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X STUDENT Primary

Addresses

Primary practice location

3900 Junius St Ste 705
Dallas, TX 75246-1627

Mailing address

3900 Junius St Ste 705
Dallas, TX 75246-1627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230623001573 TX Practitioner - Physician Assistant 3678931680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

12505 Lebanon Rd
Suite 1442
Frisco, TX 75035-8298
Phone (972) 963-3550

3800 Gaylord Pkwy
Suite 830
Frisco, TX 75034-9416
Phone (469) 800-5750

4001 Worth St
Dallas, TX 75246-1608

7217 Telecom Pkwy
Garland, TX 75044-2203

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
  • Baylor Scott & White Medical Center - Centennial Hospital, Frisco, TX, CCN 450885
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince May 30, 2023 Accepting new patients
Healthtexas Provider Network CurrentSince May 30, 2023 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

3900 Junius St
Ste 705
Dallas, TX 75246
Phone (214) 820-9520

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

7217 Telecom Pkwy
Ste 325
Garland, TX 75044

Interoperability endpoints

  • Direct secure messaging: kbowden1183518@direct.sw.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1912600412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST STE 705",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST STE 705",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461627",
            "telephone_number": "972-817-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWDEN",
        "first_name": "KYRA",
        "middle_name": "LANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "STUDENT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.