Organization
RETINA CONSULTANTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY MILTON COWAN MD (VICE PRESIDENT)
(817) 332-1782
Entity
Organization
Contact information
Practice address
909 9TH AVENUE, SUTIE 404, FORT WORTH, TX 76104-3918
(817) 332-1782
(817) 336-8619
Mailing address
909 9TH AVENUE, #404, FORT WORTH, TX 76104-3918
(817) 332-1782
(817) 336-8619
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082344501
—
TX
Enumeration date
11/16/2005
Last updated
01/11/2010
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