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NPI Code Detail

MEDICARE: DR. KATHLEEN E GOFF O.D.

MEDICARE: DR. KATHLEEN E GOFF O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152WP0200XPediatric Optometrist02539TGTX
2152W00000XOptometrist02539TGTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180664QOTHERTXBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144223058
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN E GOFF O.D.
Provider Business Mailing Address
First Line : PO BOX 3835
Second Line :
City : EL PASO
State : TX
Zip : 79923-3835
Country : US
Telephone Number : 915-544-6700
Fax Number : 915-544-6707
Provider Business Practice Location Address
First Line : 2222 MONTANA AVE
Second Line :
City : EL PASO
State : TX
Zip : 79903-3602
Country : US
Telephone Number : 915-544-6700
Fax Number : 915-544-6707
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/15/2015

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