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General NPI Number Information
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NPI Number | 1720204001
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Entity Type | Organization
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Legal Business Name | ROSE Z. GOWEN, M.D., P.A.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 800 W JEFFERSON ST SUITE 100
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6329
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Country | US
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Telephone | 956-504-9199
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Fax |
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Provider Business Mailing Address
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Address Line | 800 W JEFFERSON ST SUITE 100
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6329
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Country | US
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Telephone | 956-504-9199
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Fax |
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Authorized Official
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Title or Position | BILLING STAFF
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Name | MR. OMAR ORTEGA
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Credential |
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Telephone | 956-504-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 9089925
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License Number State | TX
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