Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | K5592 | TX |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | K5592 | TX |
NPI | 1093779258 |
---|---|
Provider Name | Dr. Robert C Kowal |
First Address | Dallas, TX 75226-1339 |
Second Address | Dallas, TX 75226-1339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 12/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105069203 | (05) | TX |
105069204 | (05) | TX |
105069205 | (05) | TX |
G86852 | (02) | TX |