Healthcare Provider Details

I. General information

NPI: 1003001918
Provider Name (Legal Business Name): KAREN KAY GOAD PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1162 HWY 327 EAST
SILSBEE TX
77656
US

IV. Provider business mailing address

45 IDLEWILD ST
LUMBERTON TX
77657-6934
US

V. Phone/Fax

Practice location:
  • Phone: 409-385-2500
  • Fax: 409-385-2502
Mailing address:
  • Phone: 409-755-2570
  • Fax: 409-385-2502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1008803
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number1008803
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: