Jesse C Goss in Fort Worth - Prosthetic/orthotic Supplier
Jesse C Goss - NPI 1114102787
Jesse C Goss is a Prosthetic/orthotic Supplier in Fort Worth, Texas. Jesse C Goss practices all healthcare services and medical treatments related to Prosthetic/orthotic Supplier. The NPI Number for Jesse C Goss is 1114102787. The last update date is 2008-06-20.
Jesse C Goss's current location address is 6901 River Park Cir, Fort Worth, Texas. You can contact this provider via phone number 8177320800 and fax number 8175965119. The mailing address for Jesse C Goss is 6901 River Park Cir, Fort Worth, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jesse C Goss |
|---|---|
| Address | 6901 River Park Cir, Fort Worth, Texas |
| Phone Number | 8177320800 |
| Fax Number | 8175965119 |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1114102787 |
|---|---|
| Provider Enumeration Date | 2008-01-02 |
| Last Updated Date | 2008-06-20 |
Provider Mailing Address Detail
| Address | 6901 River Park Cir |
|---|---|
| City | Fort Worth |
| State | Texas (TX) |
| Post Code | 761168465 |
| Phone Number | 8177320800 |
| Fax Number | 8175965119 |
Provider's Primary Taxonomy Detail
| Speciality | Prosthetic/orthotic Supplier |
|---|---|
| Taxonomy | 335E00000X |
| Licence No | 1313 |
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Definition: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological f |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1313 | TX | TEXAS BOARD |
Post Comment/ Review Below
What is the Jesse C Goss's unique identification number?
The Jesse C Goss has been assigned the NPI (National Provider Identifier) Number 1114102787 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Jesse C Goss?
The Jesse C Goss is situated at 6901 River Park Cir, in the city of Fort Worth, state of TX, with the zip code 761168465.
What is the Jesse C Goss's specialty and taxonomy code?
The Jesse C Goss's specialty is Prosthetic/orthotic Supplier, and the corresponding taxonomy code is 335E00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1114102787 to Jesse C Goss?
The Jesse C Goss received its 1114102787 assignment from the Centers for Medicare & Medicaid Services on 2008-01-02.
As of what date was the information pertaining to Jesse C Goss, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Jesse C Goss, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2008-06-20.