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General NPI Number Information
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NPI Number | 1760632970
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Entity Type | Organization
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Legal Business Name | TEXAS INPATIENT PEDIATRICS, PA
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 13022 JONES MALTSBERGER RD
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City | SAN ANTONIO
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State | TX
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Zip | 78247-4219
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Country | US
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Telephone | 210-491-0772
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Fax | 210-481-2769
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Provider Business Mailing Address
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Address Line | PO BOX 2954 MSC 300
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City | SAN ANTONIO
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State | TX
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Zip | 78299-2954
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Country | US
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Telephone | 210-490-5027
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Fax | 210-490-5077
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS J. GOWAN
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Credential | M.D.
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Telephone | 210-491-0772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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