Provider Demographics
NPI:1518789502
Name:BOWDEN MATHEWS, MADYSON RYANE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MADYSON
Middle Name:RYANE
Last Name:BOWDEN MATHEWS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 LOGANSPORT ST
Mailing Address - Street 2:
Mailing Address - City:CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:75935-3521
Mailing Address - Country:US
Mailing Address - Phone:936-591-8380
Mailing Address - Fax:
Practice Address - Street 1:620 TENAHA ST
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-3404
Practice Address - Country:US
Practice Address - Phone:936-598-2716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical