Phillip Bowes Bandel, MD
Individual provider Active NPI Dermatology Physician · Paris, TX
NPI 1912957101 · NPPES record last updated May 16, 2008
Key facts
- NPI
- 1912957101
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- F2165 (TX)
- Practice address
- 911 Lamar Ave
Paris, TX 75460-4681 - Phone
- (903) 785-7546
- Fax
- (903) 785-8445
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110517000665 | TX | Practitioner - Dermatology | 5395921845 | Practice locations: Paris, TX |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F2165 | TX | MD | Dermatology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | F2165 | TX | Yes |
Addresses
Primary practice location
911 Lamar Ave
Paris, TX 75460-4681
Mailing address
911 Lamar Ave
Paris, TX 75460-4681
Phone (903) 785-7546
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00794K | Other | TX | MEDICARE |
| 081161401 | Medicaid | TX | |
| 826072054 | Other | TX | RR MEDICARE |
| 00794K | Other | TX | BCBS |
| 100082700A | Other | OK | OK MEDICAID |
Other providers in Paris, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.