Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | S0891 | TX |
Y | 111NI0900X | Internist | S0891 | TX |
NPI | 1003263732 |
---|---|
Provider Name | Jasmine Gowarty |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2016 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
651460 | PHYSICIAN IN TRAINING PERMIT (PIT) FROM THE TEXAS MEDICAL BOARD (01) | TX |