Individual
DR. JACK MCGOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4841 YAGER LN, MANOR, TX 78653-9718
(512) 427-6273
Mailing address
4841 YAGER LN, MANOR, TX 78653-9718
(512) 427-6273
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
9856
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11457838
CAQH NUMBER
TX
01
—
8R3490
BCBS PROVIDER NUMBER
TX
Enumeration date
02/08/2007
Last updated
08/17/2007
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