Healthcare Provider Details

I. General information

NPI: 1376821256
Provider Name (Legal Business Name): VAN CHRISTOPHER COWAN PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 S 1ST ST
AUSTIN TX
78745
US

IV. Provider business mailing address

106 S MAYS ST STE 100
ROUND ROCK TX
78664-5850
US

V. Phone/Fax

Practice location:
  • Phone: 512-441-4747
  • Fax:
Mailing address:
  • Phone: 512-238-1146
  • Fax: 512-238-1148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number50194
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: