Individual
JEFFREY L MCGOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6301 HARRIS PKWY STE 300, FORT WORTH, TX 76132-4249
(817) 877-3432
(817) 346-4394
Mailing address
6301 HARRIS PKWY STE 300, FORT WORTH, TX 76132-4249
(817) 877-3432
(817) 346-4394
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
L8833
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181787603
—
TX
01
—
8P6302
BLUE CROSS/BLUE SHIELD
TX
01
—
L8833
STATE LICENSE
TX
Enumeration date
06/01/2005
Last updated
03/20/2015
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