MEDICARE: IDEN M COWAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	E7901	AR
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	S2007	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S2007	OTHER	TX	MEDICAL LICENSE

General Provider Information

NPI Number	:	1700029832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IDEN M COWAN M.D.

Provider Business Mailing Address
First Line	:	7951 SHOAL CREEK BLVD STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-7582
Country	:	US
Telephone Number	:	512-584-8404
Fax Number	:	737-377-0442

Provider Business Practice Location Address
First Line	:	8015 SHOAL CREEK BLVD STE 103
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-8051
Country	:	US
Telephone Number	:	512-467-7246
Fax Number	:	512-467-7247

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2009
Last Update Date	:	05/18/2026

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Directions to “ IDEN M COWAN M.D.” Practice Location

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