Individual
GOWTHAM JONNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3705 MEDICAL PKWY STE 460, AUSTIN, TX 78705-1024
(512) 454-5851
(512) 454-5853
Mailing address
3705 MEDICAL PKWY STE 460, AUSTIN, TX 78705-1024
(512) 454-5851
(512) 454-5853
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R1552
TN
207WX0107X
Retina Specialist (Ophthalmology) Physician
R1552
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2011
Last updated
03/11/2025
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