MEDICARE: DR. CHRISTOPHER M GODELL M.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
1	207RG0100X	Gastroenterology Physician	M1113	TX

General Provider Information

NPI Number	:	1164407615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER M GODELL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 10597
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78766-1597
Country	:	US
Telephone Number	:	512-485-5878
Fax Number	:	512-420-0397

Provider Business Practice Location Address
First Line	:	7200 WYOMING SPRINGS DR STE 1300
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4306
Country	:	US
Telephone Number	:	512-244-2273
Fax Number	:	512-244-3179

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	08/23/2023

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