Provider Demographics
NPI:1649396920
Name:COWEN, ALAN E (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:E
Last Name:COWEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2848 BROOKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5545
Mailing Address - Country:US
Mailing Address - Phone:817-424-3112
Mailing Address - Fax:817-488-2820
Practice Address - Street 1:1600 W COLLEGE ST
Practice Address - Street 2:SUITE 1101
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3580
Practice Address - Country:US
Practice Address - Phone:817-424-3112
Practice Address - Fax:817-488-2820
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF3083207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00074KMedicare ID - Type Unspecified
B22006Medicare UPIN