Individual provider · NPI-1

Dr. Thomas Michael Mcgovern, MD

Surgery · Tyler, TX

NPI number1780606905

StatusActive

Last updated in NPPESApr 12, 2021

Details

NPI: 1780606905
Entity type: Individual (NPI-1)
Name: Dr. Thomas Michael Mcgovern
Credential: MD
Sex: Male
Sole proprietor: Yes
Enumeration date: Jul 24, 2006
Certification date: Apr 12, 2021
Last updated: Apr 12, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208600000X	Surgery	K7057	TX	Yes
2086S0127X	Surgery, Trauma Surgery	K7057	TX
208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)	K7057	TX

Practice location

935 S Baxter Ave
Tyler, TX 75701-2245

Phone 903-596-7775 · Fax 903-596-7778

Mailing address

935 S Baxter Ave
Tyler, TX 75701-2245

Phone 903-596-7775 · Fax 903-596-7778

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