MEDICARE: DR. JOSEPH S. GOETZ 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	207W00000X	Ophthalmology Physician	H7421	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00098108	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	95-3891546	OTHER	CA	TAX IDENTIFICATION NUMBER
3	G039888	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1861487977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH S. GOETZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 128
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77402-0128
Country	:	US
Telephone Number	:	281-833-3330
Fax Number	:	281-833-3323

Provider Business Practice Location Address
First Line	:	4660 BEECHNUT ST STE 214
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-1805
Country	:	US
Telephone Number	:	713-665-9800
Fax Number	:	713-665-9809

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	08/11/2020

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