Individual
GORDON G MCWATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
201 WALLS DR, CLEBURNE, TX 76033-4007
(817) 566-7601
Mailing address
PO BOX 8549, FORT WORTH, TX 76124-0549
(817) 451-4208
(817) 563-3699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J6589
TX
207Q00000X
Family Medicine Physician
J6589
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076DK
BCBS
TX
05
—
120600503
—
TX
Enumeration date
06/01/2006
Last updated
07/02/2013
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