Individual
SARAH E GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
802 MEDICAL CIRCLE, SUITE 100, LONGVIEW, TX 75605-5100
(903) 757-6042
(903) 232-8213
Mailing address
PO BOX 610393, DALLAS, TX 75261-0393
(903) 291-6187
(903) 237-1810
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
714260
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325488002
—
TX
Enumeration date
09/12/2013
Last updated
09/23/2019
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