Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 075209 | GA |
Y | 208200000X | Surgeon | R4048 | TX |
Y | 208600000X | Surgeon | R4048 | TX |
NPI | 1679788947 |
---|---|
Provider Name | Christie W Gooden |
First Address | Dallas, TX 75230-5647 |
Second Address | Atlanta, GA 30309-1281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 04/01/2022 |