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General NPI Number Information
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NPI Number | 1629248075
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Entity Type | Organization
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Legal Business Name | SHANE COWAN ENTERPRISES, LLC
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Dates
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Enumeration Date | 03/01/2008
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 1824 W VIRGINIA ST
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City | MCKINNEY
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State | TX
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Zip | 75069-7865
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Country | US
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Telephone | 214-491-4944
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Fax | 214-491-4945
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Provider Business Mailing Address
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Address Line | 1824 W VIRGINIA ST
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City | MCKINNEY
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State | TX
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Zip | 75069-7865
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Country | US
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Telephone | 214-491-4944
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Fax | 214-491-4945
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHANE COWAN
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Credential | D.C.
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Telephone | 214-491-4944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 8674
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License Number State | TX
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