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General NPI Number Information
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NPI Number | 1316758998
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Entity Type | Organization
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Legal Business Name | MARK J GODAT MD PA
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 12201 MERIT DR STE 400
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City | DALLAS
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State | TX
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Zip | 75251-3117
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Country | US
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Telephone | 469-840-4888
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Fax | 469-840-4886
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Provider Business Mailing Address
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Address Line | 7009 LAKE EDGE DR
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City | DALLAS
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State | TX
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Zip | 75230-2368
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Country | US
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Telephone | 214-893-8065
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Fax | 214-696-9483
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | JAN SMITH GODAT
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Credential |
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Telephone | 214-893-8065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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