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General NPI Number Information
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NPI Number | 1003955584
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Entity Type | Individual
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Provider Name | PAUL JOHN GODLEY PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2601 THORNTON LANE SUITE A
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City | TEMPLE
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State | TX
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Zip | 76502
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Country | US
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Telephone | 254-742-3161
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Fax | 254-742-3131
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Provider Business Mailing Address
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Address Line | 1801 CANYON SPGS
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City | BELTON
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State | TX
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Zip | 76513-1001
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Country | US
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Telephone | 254-742-3161
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Fax | 254-742-3131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 24465
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License Number State | TX
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