Individual
MR. SCOTT FREDERICK MCGOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
724 W MAIN ST STE 180, LEWISVILLE, TX 75067-3583
(972) 434-6024
(972) 434-2784
Mailing address
724 W MAIN ST, STE 180, LEWISVILLE, TX 75067-3583
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1116499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1643306 01
—
TX
01
—
83610T
BLUE CROSS PROVIDER NUMBE
TX
Enumeration date
08/10/2006
Last updated
08/29/2016
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