Individual
DR. THOMAS MICHAEL MCGOVERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
935 S BAXTER AVE, TYLER, TX 75701-2245
(903) 596-7775
(903) 596-7778
Mailing address
935 S BAXTER AVE, TYLER, TX 75701-2245
(903) 596-7775
(903) 596-7778
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K7057
TX
2086S0127X
Trauma Surgery Physician
K7057
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
K7057
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0094PT
BCBS
TX
05
—
039010604
—
TX
Enumeration date
07/24/2006
Last updated
04/12/2021
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