Provider Demographics
NPI:1831205350
Name:GEORGE, NANCY COWART (OD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:COWART
Last Name:GEORGE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 CALHOUN RD
Mailing Address - Street 2:ROOM 2107
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77204-2020
Mailing Address - Country:US
Mailing Address - Phone:713-743-2020
Mailing Address - Fax:713-743-0963
Practice Address - Street 1:1809 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-8310
Practice Address - Country:US
Practice Address - Phone:713-547-8085
Practice Address - Fax:713-743-0963
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02922TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124800705Medicaid
TX124800706Medicaid
TX112409104Medicaid
TX82408EOtherBLUE CROSS
TXTXB112482Medicare UPIN
TX82408EOtherBLUE CROSS
TXU24230Medicare UPIN
TX8G2435Medicare ID - Type Unspecified