Individual
GARRETT KENNETH GOTWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 456-2564
(214) 456-2567
Mailing address
P.O. BOX 845347, DALLAS, TX 75284-5347
(214) 456-2564
(214) 456-2567
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
N5691
TX
208000000X
Pediatrics Physician
Primary
N5691
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2007
Last updated
08/29/2014
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