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Organization

PETER G. MCDOUGALL M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PETER GORDON MCDOUGALL M.D. (OWNER)
(817) 307-5101
Entity
Organization

Contact information

Practice address
6609 CROOKED STICK DR, FORT WORTH, TX 76132
(817) 307-5101
Mailing address
6609 CROOKED STICK DR, FORT WORTH, TX 76132-4526
(817) 307-5101

Taxonomy

Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
E8068
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00766R
MEDICARE GROUP NUMBER
TX
Enumeration date
08/29/2007
Last updated
02/11/2016
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