Basic Information
| Provider Information | |||||||||
| NPI: | 1245354307 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JENNIFER T MCGAUGHY DO PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 822 | ||||||||
| Address2: | |||||||||
| City: | PERRYTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 790700822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8064353606 | ||||||||
| FaxNumber: | 8064352067 | ||||||||
| Practice Location | |||||||||
| Address1: | 3101 GARRETT DR | ||||||||
| Address2: | |||||||||
| City: | PERRYTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 790705323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8064353606 | ||||||||
| FaxNumber: | 8064352067 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 08/27/2014 | ||||||||
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| AuthorizedOfficialLastName: | MCGAUGHY | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8064340622 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | L9981 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.