MEDICARE: CHRISTINE C GOOCH

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1841840915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE C GOOCH

Provider Business Mailing Address
First Line	:	14601 BELLAIRE BLVD UNIT 214
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-2505
Country	:	US
Telephone Number	:	832-384-6349
Fax Number	:

Provider Business Practice Location Address
First Line	:	8145 HIGHWAY 6 S STE 130
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5740
Country	:	US
Telephone Number	:	832-328-4104
Fax Number	:	832-328-4162

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

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	09/19/2019

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Directions to “ CHRISTINE C GOOCH ” Practice Location

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