Healthcare Provider Details

I. General information

NPI: 1497701916
Provider Name (Legal Business Name): RICHARD S COWLES PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 DECKER DR STE 150
IRVING TX
75062-8198
US

IV. Provider business mailing address

580 DECKER DR STE 150
IRVING TX
75062-8198
US

V. Phone/Fax

Practice location:
  • Phone: 972-584-9151
  • Fax:
Mailing address:
  • Phone: 972-584-9151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number33276
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1680
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number8527
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: