Individual
DR. MICHAEL R COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4200 SOUTH FWY STE 100, FORT WORTH, TX 76115-1407
(817) 750-7334
Mailing address
4200 SOUTH FWY STE 100, FORT WORTH, TX 76115-1407
(817) 750-7334
(817) 910-6120
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
H9459
TX
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
H9459
TX
208000000X
Pediatrics Physician
Primary
H9459
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137166812
—
TX
Enumeration date
10/18/2005
Last updated
08/25/2021
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