Healthcare Provider Details

I. General information

NPI: 1639653348
Provider Name (Legal Business Name): COMVET SURGICAL AFFILIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22202 MEANDERING SPRINGS DR
SPRING TX
77389-1463
US

IV. Provider business mailing address

PO BOX 2550
ROWLETT TX
75030-2550
US

V. Phone/Fax

Practice location:
  • Phone: 214-227-2457
  • Fax: 214-764-0880
Mailing address:
  • Phone: 214-227-2457
  • Fax: 214-764-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DAVID CLARENCE MCCOWAN
Title or Position: LICENSED SURGICAL PA/ASSISTANT
Credential:
Phone: 832-353-0636