MEDICARE: MAURICE ERVING GOODWIN SLP

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	235Z00000X	Speech-Language Pathologist	115183	TX
2	235Z00000X	Speech-Language Pathologist	4489-154	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4489-154	OTHER	WI	LICENSE

General Provider Information

NPI Number	:	1619499837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURICE ERVING GOODWIN SLP

Provider Business Mailing Address
First Line	:	6550 FANNIN ST STE 1723
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2747
Country	:	US
Telephone Number	:	713-796-2181
Fax Number	:

Provider Business Practice Location Address
First Line	:	6550 FANNIN ST STE 1723
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2747
Country	:	US
Telephone Number	:	713-796-2181
Fax Number	:

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

Provider Enumeration Date	:	07/10/2017
Last Update Date	:	05/10/2025

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Directions to “ MAURICE ERVING GOODWIN SLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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