Provider Demographics
NPI:1194946434
Name:JOWERS, BRENDA JO
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JO
Last Name:JOWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MERKEL
Mailing Address - State:TX
Mailing Address - Zip Code:79536-3062
Mailing Address - Country:US
Mailing Address - Phone:325-928-4249
Mailing Address - Fax:
Practice Address - Street 1:1502 N 4TH ST
Practice Address - Street 2:
Practice Address - City:MERKEL
Practice Address - State:TX
Practice Address - Zip Code:79536-3062
Practice Address - Country:US
Practice Address - Phone:325-928-4249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117167372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion