Clyde Leroy Goodman in Fort Worth - General Practice

Clyde Leroy Goodman - NPI 1801823083

Clyde Leroy Goodman is a General Practice in Fort Worth, Texas. Clyde Leroy Goodman practices all healthcare services and medical treatments related to General Practice. The NPI Number for Clyde Leroy Goodman is 1801823083. The last update date is 2012-10-04.

Clyde Leroy Goodman's current location address is 4840 Bryant Irvin Ct., Fort Worth, Texas. You can contact this provider via phone number 8173354549 and fax number 8173770970. The mailing address for Clyde Leroy Goodman is 4840 Bryant Irvin Ct., Fort Worth, Texas. To know further, please read the information below!

Provider Profile Detail

Provider Name Clyde Leroy Goodman
Address 4840 Bryant Irvin Ct., Fort Worth, Texas
Phone Number 8173354549
Fax Number 8173770970
Sole Proprietor N
Credentials MD

NPI Number Detail

NPI Number 1801823083
Provider Enumeration Date 2006-06-26
Last Updated Date 2012-10-04

Provider Mailing Address Detail

Address 4840 Bryant Irvin Ct.
City Fort Worth
State Texas (TX)
Post Code 761077680
Phone Number 8173354549
Fax Number 8173770970

Provider's Primary Taxonomy Detail

Speciality General Practice
Taxonomy 208D00000X
Licence No D7984
Definition:
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
34680101 TX --

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FAQs about Clyde Leroy Goodman

What is the unique 10-digit identifier code issued to Clyde Leroy Goodman by the Centers for Medicare & Medicaid Services?

The Clyde Leroy Goodman has been assigned the NPI (National Provider Identifier) 1801823083 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.

Can you provide the Clyde Leroy Goodman's physical address?

The Clyde Leroy Goodman is physically located at 4840 Bryant Irvin Ct., in the city of Fort Worth, TX, with the postal code 761077680.

What is Clyde Leroy Goodman's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?

The primary field of medical specialization for Clyde Leroy Goodman is General Practice, and the taxonomy classification code that categorizes this area of expertise is 208D00000X.

When did the Clyde Leroy Goodman receive its 1801823083?

The Clyde Leroy Goodman was issued its 1801823083 on 2006-06-26, which is the date when the organization was assigned this unique identifier.

When was the information regarding Clyde Leroy Goodman most recently updated?

The details pertaining to the Clyde Leroy Goodman, including its address, specialty, and other relevant information, were last refreshed on 2012-10-04.

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