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General NPI Number Information
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NPI Number | 1255365185
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Entity Type | Organization
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Legal Business Name | GOODALE MEDICAL LP
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 06/05/2012
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Provider Practice Location Address
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Address Line | 2614 INDUSTRIAL LN STE B
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City | GARLAND
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State | TX
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Zip | 75041-2365
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Country | US
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Telephone | 214-932-6202
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Fax |
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Provider Business Mailing Address
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Address Line | 2614 INDUSTRIAL LN STE B
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City | GARLAND
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State | TX
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Zip | 75041-2365
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS FARNSWORTH GOODALE
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Credential |
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Telephone | 214-328-0019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0011294
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License Number State | TX
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