Provider Demographics
NPI:1821384157
Name:MICHAEL W. COWART, M.D., P.A.
Entity Type:Organization
Organization Name:MICHAEL W. COWART, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COWART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-475-3030
Mailing Address - Street 1:6617 HERITAGE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-8750
Mailing Address - Country:US
Mailing Address - Phone:972-475-3030
Mailing Address - Fax:972-475-0707
Practice Address - Street 1:6617 HERITAGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-8750
Practice Address - Country:US
Practice Address - Phone:972-475-3030
Practice Address - Fax:972-475-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4254207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136719502Medicaid
TX00G01QMedicare PIN
TX136719502Medicaid