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NPI Code Detail

MEDICARE: DR. COREY ELAM GOLDSMITH MD

MEDICARE:  DR. COREY ELAM GOLDSMITH  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
12084N0400XNeurology PhysicianM7216TX

Other Identifiers

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

General Provider Information

NPI Number : 1780877472
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COREY ELAM GOLDSMITH MD
Provider Business Mailing Address
First Line : 2525 HOLLY HALL ST
Second Line :
City : HOUSTON
State : TX
Zip : 77054-4124
Country : US
Telephone Number : 713-566-3689
Fax Number : 713-566-3675
Provider Business Practice Location Address
First Line : 2525 HOLLY HALL ST
Second Line :
City : HOUSTON
State : TX
Zip : 77054-4124
Country : US
Telephone Number : 713-566-3689
Fax Number : 713-566-3675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2007
Last Update Date : 06/05/2015

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