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Organization

BERNARD J. GOTWAY, PH.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BERNARD J. GOTWAY PH.D. (PRESIDENT / OWNER)
(972) 918-9333
Entity
Organization

Contact information

Practice address
1701 GATEWAY BLVD, STE 447, RICHARDSON, TX 75080-3572
(972) 918-9333
(972) 783-8444
Mailing address
1701 GATEWAY BLVD, STE 447, RICHARDSON, TX 75080-3572
(972) 918-9333
(972) 783-8444

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22116
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
032366901
TX
Enumeration date
06/02/2011
Last updated
06/02/2011
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