Provider Demographics
NPI:1093779258
Name:KOWAL, ROBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:KOWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:621 N HALL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1339
Mailing Address - Country:US
Mailing Address - Phone:469-800-7400
Mailing Address - Fax:469-800-7440
Practice Address - Street 1:621 N HALL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1339
Practice Address - Country:US
Practice Address - Phone:469-800-7400
Practice Address - Fax:469-800-7440
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2015-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK5592207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105069203Medicaid
TX105069204Medicaid
TX105069205Medicaid
TX343006YKTPMedicare PIN
TX105069203Medicaid
TX105069204Medicaid
TX343006YKY6Medicare PIN