Provider Demographics
NPI:1194760249
Name:COMPREHENSIVE WOMENS HEALTHCARE PA
Entity type:Organization
Organization Name:COMPREHENSIVE WOMENS HEALTHCARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:COWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-424-3112
Mailing Address - Street 1:1600 W COLLEGE STREET
Mailing Address - Street 2:STE 1101
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051
Mailing Address - Country:US
Mailing Address - Phone:817-424-3112
Mailing Address - Fax:817-488-2820
Practice Address - Street 1:1600 W COLLEGE STREET
Practice Address - Street 2:STE 1101
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:817-424-3112
Practice Address - Fax:817-488-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3083207V00000X
TXH0090207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080695201Medicaid
TX102035601Medicaid
TX102037201Medicaid
TX102035601Medicaid
B22006Medicare UPIN