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General NPI Number Information
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NPI Number | 1720622954
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Entity Type | Organization
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Legal Business Name | RYAN C COWAN DDS PC
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Dates
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Enumeration Date | 10/31/2019
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 201 OLD BRANDON RD
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City | HILLSBORO
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State | TX
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Zip | 76645-2326
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Country | US
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Telephone | 254-582-9555
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Fax | 254-582-8477
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Provider Business Mailing Address
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Address Line | PO BOX 1017
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City | HILLSBORO
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State | TX
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Zip | 76645-1017
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Country | US
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Telephone | 254-582-9555
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Fax | 254-582-8477
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Authorized Official
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Title or Position | OWNER
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Name | RYAN C COWAN
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Credential | DDS PC
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Telephone | 972-415-4359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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