Individual
COREY MICHAEL MOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 450-9000
(210) 450-4903
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 450-9000
(210) 450-4903
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1264329
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408325501
—
TX
01
—
408325502
CSHCN
TX
Enumeration date
01/17/2020
Last updated
05/11/2020
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