Organization
MARY S. GOSWITZ MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SUE GOSWITZ MD (PRESIDENT)
(281) 420-8557
Entity
Organization
Contact information
Practice address
4021 GARTH RD, SUITE 105, BAYTOWN, TX 77521-3160
(281) 420-8557
(281) 427-2911
Mailing address
PO BOX 1297, BAYTOWN, TX 77522-1297
(281) 420-8557
(281) 427-2911
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
J6972
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018GK
BCBS
—
01
—
10017453
AMERIGROUP
—
05
—
103039703
—
TX
Enumeration date
03/29/2010
Last updated
10/28/2010
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