Individual
MR. GREGORY WADE COWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
815 N VIRGINIA ST, PORT LAVACA, TX 77979-3025
(361) 552-6713
(361) 552-0338
Mailing address
38402 WILDWOOD PT, MAGNOLIA, TX 77354-6643
(713) 302-5036
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
239435
TX
Other
Enumeration date
08/13/2006
Last updated
07/09/2007
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