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General NPI Number Information
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NPI Number | 1104711035
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Entity Type | Individual
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Provider Name | KYLE WOLFGANG GOODIER DC
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Gender | Male
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 6301 GASTON AVE STE 1104
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City | DALLAS
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State | TX
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Zip | 75214-3954
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Country | US
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Telephone | 469-909-3669
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 VICKIE DR
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City | IRVING
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State | TX
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Zip | 75060-3650
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Country | US
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Telephone | 469-332-8454
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 16649
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License Number State | TX
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