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General NPI Number Information
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NPI Number | 1407082357
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Entity Type | Individual
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Provider Name | MARIA E. GOEN LSA
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Gender | Female
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 11/08/2017
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Provider Practice Location Address
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Address Line | 3808 LAKE ST
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City | HOUSTON
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State | TX
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Zip | 77098-5524
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Country | US
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Telephone | 713-850-0870
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Fax | 832-681-9050
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Provider Business Mailing Address
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Address Line | 3808 LAKE ST
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City | HOUSTON
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State | TX
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Zip | 77098-5524
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Country | US
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Telephone | 713-898-5449
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Fax | 832-681-9050
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | SA00389
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License Number State | TX
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