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NPI Code Detail

MEDICARE: DR. BRIAN JOSEPH GOERIG MD

MEDICARE: DR. BRIAN JOSEPH GOERIG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QS0010XSports Medicine (Family Medicine) PhysicianL7619TX
2207Q00000XFamily Medicine PhysicianL7619TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2L7619OTHERTXTEXAS MEDICAL BOARD

General Provider Information

NPI Number : 1477593051
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN JOSEPH GOERIG MD
Provider Business Mailing Address
First Line : 1730 BIRMINGHAM RD STE 100
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-4063
Country : US
Telephone Number : 979-703-1902
Fax Number : 979-703-6104
Provider Business Practice Location Address
First Line : 1730 BIRMINGHAM RD STE 100
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-4063
Country : US
Telephone Number : 979-703-1902
Fax Number : 979-703-6104
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 01/29/2024

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Directions to “ DR. BRIAN JOSEPH GOERIG MD” Practice Location

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