Healthcare Provider Details

I. General information

NPI: 1760632970
Provider Name (Legal Business Name): TEXAS INPATIENT PEDIATRICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13022 JONES MALTSBERGER RD
SAN ANTONIO TX
78247-4219
US

IV. Provider business mailing address

PO BOX 2954 MSC 300
SAN ANTONIO TX
78299-2954
US

V. Phone/Fax

Practice location:
  • Phone: 210-491-0772
  • Fax: 210-481-2769
Mailing address:
  • Phone: 210-490-5027
  • Fax: 210-490-5077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS J. GOWAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 210-491-0772