Individual
JACK DAVID MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6701 FANNIN ST, HOUSTON, TX 77030-2608
(832) 824-1000
Mailing address
2 GREENWAY PLZ STE 300, HOUSTON, TX 77046-0207
(832) 828-3660
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
H1147
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
H1147
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00J48W
BLUE CROSS
TX
05
—
130804101
—
TX
Enumeration date
07/05/2006
Last updated
08/07/2013
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