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General NPI Number Information
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NPI Number | 1487841912
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Entity Type | Organization
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Legal Business Name | LINDA A. GOODRUM, M.D.,P.A.
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 251 MEDICAL CENTER BLVD STE 300A
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City | WEBSTER
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State | TX
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Zip | 77598-4242
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Country | US
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Telephone | 281-338-7693
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Fax | 281-338-8849
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Provider Business Mailing Address
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Address Line | 251 MEDICAL CENTER BLVD STE 300A
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City | WEBSTER
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State | TX
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Zip | 77598-4242
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Country | US
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Telephone | 281-338-7693
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Fax | 281-338-8849
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LINDA A GOODRUM
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Credential | M.D.
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Telephone | 281-338-7693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | J4827
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License Number State | TX
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