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Individual

SUSAN LYNNE MCGOVERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
N7722
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
218093701
TX
01
8CQ120
BCBS
TX
Enumeration date
09/20/2010
Last updated
07/27/2012
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