Organization
THOMAS M MCGOVERN MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS MICHAEL MCGOVERN MD (PRESIDENT)
(903) 596-7775
Entity
Organization
Contact information
Practice address
935 S BAXTER AVE, TYLER, TX 75701-2245
(903) 596-7775
(903) 596-7778
Mailing address
935 S BAXTER AVE, TYLER, TX 75701-2245
(903) 596-7775
(903) 596-7778
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K7057
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39010603
—
TX
Enumeration date
04/21/2016
Last updated
04/27/2021
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