Provider Demographics
NPI:1639653348
Name:COMVET SURGICAL AFFILIATES LLC
Entity Type:Organization
Organization Name:COMVET SURGICAL AFFILIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED SURGICAL PA/ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CLARENCE
Authorized Official - Last Name:MCCOWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-353-0636
Mailing Address - Street 1:PO BOX 2550
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-2550
Mailing Address - Country:US
Mailing Address - Phone:214-227-2457
Mailing Address - Fax:214-764-0880
Practice Address - Street 1:22202 MEANDERING SPRINGS DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-1463
Practice Address - Country:US
Practice Address - Phone:214-227-2457
Practice Address - Fax:214-764-0880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty