Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 7850 | TX |
Y | 111NR0400X | Rehabilitation Chiropractor | 7850 | TX |
NPI | 1285711804 |
---|---|
Provider Name | Dr. William E. Goolsby |
First Address | Aubrey, TX 76227-8309 |
Second Address | Aubrey, TX 76227-8309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 22/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0030CZ | BCBS GROUP NUMBER (01) | TX |
5080756 | AETNA PROVIDER NUMBER (01) | TX |
87570S | BCBS PROVIDER NUMBER (01) | TX |
U70214 | (02) | TX |