Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD.201885 | LA |
N | 2080P0208X | Pediatric Infectious Diseases | MD.201885 | LA |
NPI | 1588682462 |
---|---|
Provider Name | Dr. Jessica Joyce Cowden |
First Address | Fort Sam Houston, TX 78234-4501 |
Second Address | Fort Sam Houston, TX 78234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 19/11/2019 |