Individual
DR. MARTIN EUGENE MCGONAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
763 N GRAHAM ST, STEPHENVILLE, TX 76401-3148
(254) 965-7870
(254) 965-5373
Mailing address
PO BOX 33648, FORT WORTH, TX 76162
(817) 579-2660
(817) 579-2663
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G6563
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126628001
—
TX
Enumeration date
09/13/2006
Last updated
07/26/2017
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