Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1008803 | TX |
N | 2251E1300X | Electrophysiology, Clinical | 1008803 | TX |
NPI | 1003001918 |
---|---|
Provider Name | Karen Kay Goad |
First Address | Lumberton, TX 77657-6934 |
Second Address | Silsbee, TX 77656 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2007 |
Last Update Date | 13/09/2007 |