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General NPI Number Information
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NPI Number | 1700909645
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Entity Type | Individual
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Provider Name | JEAN M. GOODWIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4925 FORT CROCKETT BLVD SUITE 510
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City | GALVESTON
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State | TX
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Zip | 77551-6003
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Country | US
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Telephone | 409-762-1101
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Fax | 409-762-1163
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Provider Business Mailing Address
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Address Line | 4925 FORT CROCKETT BLVD SUITE 510
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City | GALVESTON
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State | TX
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Zip | 77551-6003
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Country | US
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Telephone | 409-762-1101
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Fax | 409-762-1163
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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 | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | J3945
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | J3945
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License Number State | TX
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