MEDICARE: CHERI LYNNE GOLDSTEIN PA-C

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	363AM0700X	Medical Physician Assistant	PA00123	TX

General Provider Information

NPI Number	:	1659484079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERI LYNNE GOLDSTEIN PA-C

Provider Business Mailing Address
First Line	:	5939 HARRY HINES BLVD
Second Line	:	POB II, HQ8.827C
City	:	DALLAS
State	:	TX
Zip	:	75390-9258
Country	:	US
Telephone Number	:	214-645-1949
Fax Number	:

Provider Business Practice Location Address
First Line	:	5909 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-0001
Country	:	US
Telephone Number	:	214-645-1949
Fax Number	:

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	01/30/2013

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