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General NPI Number Information
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NPI Number | 1992020366
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Entity Type | Organization
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Legal Business Name | MARY S. GOSWITZ MD, PA
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 4021 GARTH RD SUITE 105
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City | BAYTOWN
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State | TX
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Zip | 77521-3160
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Country | US
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Telephone | 281-420-8557
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Fax | 281-427-2911
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Provider Business Mailing Address
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Address Line | PO BOX 1297
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City | BAYTOWN
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State | TX
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Zip | 77522-1297
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Country | US
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Telephone | 281-420-8557
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Fax | 281-427-2911
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY SUE GOSWITZ
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Credential | MD
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Telephone | 281-420-8557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | J6972
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License Number State | TX
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