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General NPI Number Information
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NPI Number | 1962489104
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Entity Type | Individual
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Provider Name | PETER MICHAEL MCGOWAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 5016 S. US HWY 75 RADIOLOGY DEPT
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City | DENISON
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State | TX
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Zip | 75020
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Country | US
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Telephone | 903-416-4000
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Fax | 903-327-8023
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Provider Business Mailing Address
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Address Line | 1302 N. STATE HWY 91
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City | DENISON
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State | TX
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Zip | 75020-1167
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Country | US
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Telephone | 903-465-1857
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Fax | 903-327-8023
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K0927
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DR.0067721
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | K0927
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License Number State | TX
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