Provider Demographics
NPI:1487995023
Name:BAWDEN, DAN D (CAPS)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:D
Last Name:BAWDEN
Suffix:
Gender:M
Credentials:CAPS
Other - Prefix:DR
Other - First Name:DAN
Other - Middle Name:D
Other - Last Name:BAWDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CAPS GMB CGR
Mailing Address - Street 1:5008 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3313
Mailing Address - Country:US
Mailing Address - Phone:832-731-9555
Mailing Address - Fax:
Practice Address - Street 1:5008 LOCUST ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3313
Practice Address - Country:US
Practice Address - Phone:832-731-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4301171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171WH0202XOtherHEALTH CARE PROIVDER TAXONOMY CODE