Provider Demographics
NPI:1093178782
Name:MCGOWAN, LATOIA P (DC)
Entity Type:Individual
Prefix:DR
First Name:LATOIA
Middle Name:P
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 700688
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78270-0688
Mailing Address - Country:US
Mailing Address - Phone:210-318-3007
Mailing Address - Fax:210-468-0682
Practice Address - Street 1:24022 CINCO VILLAGE CENTER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8390
Practice Address - Country:US
Practice Address - Phone:800-404-6050
Practice Address - Fax:866-313-3397
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14027111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1164OtherCHIROPRACTIC LICENSE
SD1431OtherCHIROPRACTIC LICENSE
IA107729OtherCHIROPRACTIC LICENSE
IDCHIA-2161OtherCHIROPRACTIC LICENSE
WY830OtherCHIROPRACTIC LICENSE
TX14027OtherCHIROPRACTIC LICENSE
OHDC-05095OtherCHIROPRACTIC LICENSE
MTCHI-CHI-LIC-7144OtherCHIROPRACTIC LICENSE
NMDC2294OtherCHIROPRACTIC LICENSE
MD04091OtherCHIROPRACTIC LICENSE
TN2920OtherCHIROPRACTIC LICENSE
FLCH13371OtherCHIROPRACTIC LICENSE
UT12394039-1202OtherCHIROPRACTIC LICENSE