Individual
BERNARD J. GOTWAY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1701 GATEWAY BLVD, SUITE 447, RICHARDSON, TX 75080-3572
(972) 918-9333
(972) 783-8444
Mailing address
1701 GATEWAY BLVD, SUITE 447, RICHARDSON, TX 75080-3572
(972) 918-9333
(972) 783-8444
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
TX2-2116HSP
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00BY87
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/16/2005
Last updated
07/08/2007
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