Healthcare Provider Details

I. General information

NPI: 1164963435
Provider Name (Legal Business Name): LOKESH GOYAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4821 WILLIAMS DR
CORPUS CHRISTI TX
78411-4745
US

IV. Provider business mailing address

PO BOX 60002
CORPUS CHRISTI TX
78466-0002
US

V. Phone/Fax

Practice location:
  • Phone: 361-452-8360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.014115
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS4308
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: