Doctor Name: | MR. SCOTT FREDERICK MCGOUGH |
NPI Number: | 1053322883 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 1116499 |
Business Practice Address: | 724 W Main St Ste 180 Lewisville, TX - 750673583 |
Business Phone Number: | 9724346024 |
Business Fax Number: | 9724342784 |
Mailing Address: | 3111 Kimberlee Ln, HIGHLAND VILLAGE |
State: | TX |
Postal Code: | 750771856 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 1116499 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |