Healthcare Provider Details

I. General information

NPI: 1124933155
Provider Name (Legal Business Name): MELISSA COWSAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 FM 1826
AUSTIN TX
78737-1405
US

IV. Provider business mailing address

7900 FM 1826
AUSTIN TX
78737-1405
US

V. Phone/Fax

Practice location:
  • Phone: 408-205-5406
  • Fax:
Mailing address:
  • Phone: 408-205-5406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number930712
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: