Healthcare Provider Details

I. General information

NPI: 1396822581
Provider Name (Legal Business Name): JEHANGIR W GOWANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8845 GARY BURNS DR STE 180
FRISCO TX
75034-2548
US

IV. Provider business mailing address

8845 GARY BURNS DR STE 180
FRISCO TX
75034-2548
US

V. Phone/Fax

Practice location:
  • Phone: 469-972-7860
  • Fax:
Mailing address:
  • Phone: 469-972-7860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License NumberP2250
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberP2250
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP2250
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP2250
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: