Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0761 | TX |
NPI | 1023009511 |
---|---|
Provider Name | Richard N Goad |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 16/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
126316207 | (05) | TX |
8A4606 | BCBS (01) | TX |
T13479 | (02) | TX |