Organization
PEDIATRIC URGENT CARE CENTER OF FORT WORTH, P.A..
Active
Other names
Fort Worth Concierge Plus
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL RAY COWAN D.O. (OWNER)
(817) 271-4309
Entity
Organization
Contact information
Practice address
3701 VISION DR STE 103, FORT WORTH, TX 76109-1184
(817) 259-2365
(817) 259-2366
Mailing address
3701 VISION DR STE 103, FORT WORTH, TX 76109-1184
(817) 259-2365
(817) 259-2366
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
H9459
TX
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
313997401
—
TX
Enumeration date
11/30/2011
Last updated
10/09/2023
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