Provider Demographics
NPI:1124434675
Name:MCGOWAN, SAMANTHA CATHERINE (PHARMD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:CATHERINE
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WOLFFORTH
Mailing Address - State:TX
Mailing Address - Zip Code:79382-2854
Mailing Address - Country:US
Mailing Address - Phone:806-239-3330
Mailing Address - Fax:
Practice Address - Street 1:1000 FM 300
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-6235
Practice Address - Country:US
Practice Address - Phone:806-894-7842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-05
Last Update Date:2017-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist