Provider Demographics
NPI:1457422594
Name:MCGOWN, ODETTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ODETTE
Middle Name:
Last Name:MCGOWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 WOODLAKE SQ
Mailing Address - Street 2:# 249
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3207
Mailing Address - Country:US
Mailing Address - Phone:713-727-4527
Mailing Address - Fax:713-977-4665
Practice Address - Street 1:8203 WILLOW PLACE DR S
Practice Address - Street 2:SUITE 630
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5655
Practice Address - Country:US
Practice Address - Phone:713-727-4527
Practice Address - Fax:713-977-4665
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6589101YM0800X
TX2583101YP2500X
TX246106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional