Provider Demographics
NPI:1326233974
Name:COWART, RENATE U (PTA)
Entity Type:Individual
Prefix:MS
First Name:RENATE
Middle Name:U
Last Name:COWART
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 FIRESTONE PL
Mailing Address - Street 2:
Mailing Address - City:MEADOWLAKES
Mailing Address - State:TX
Mailing Address - Zip Code:78654-6432
Mailing Address - Country:US
Mailing Address - Phone:830-613-5040
Mailing Address - Fax:
Practice Address - Street 1:127 FIRESTONE PL
Practice Address - Street 2:
Practice Address - City:MEADOWLAKES
Practice Address - State:TX
Practice Address - Zip Code:78654-6432
Practice Address - Country:US
Practice Address - Phone:830-613-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2011516225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant