Provider Demographics
NPI:1023721347
Name:COWART, CODY LLOYD (PA)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:LLOYD
Last Name:COWART
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:5510 PRESIDIO PKWY STE 2401B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3195
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5510 PRESIDIO PKWY STE 2401B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3195
Practice Address - Country:US
Practice Address - Phone:210-696-2663
Practice Address - Fax:210-696-2665
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPATEMP363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant