Provider Demographics
NPI:1003001918
Name:GOAD, KAREN KAY (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:KAY
Last Name:GOAD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 IDLEWILD ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-6934
Mailing Address - Country:US
Mailing Address - Phone:409-755-2570
Mailing Address - Fax:409-385-2502
Practice Address - Street 1:1162 HWY 327 EAST
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656
Practice Address - Country:US
Practice Address - Phone:409-385-2500
Practice Address - Fax:409-385-2502
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1008803225100000X, 2251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical