Provider Demographics
NPI:1043889892
Name:WASHINGTON, GOYITA MARIA
Entity Type:Individual
Prefix:
First Name:GOYITA
Middle Name:MARIA
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13421 SHORTLEAF DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75253-4768
Mailing Address - Country:US
Mailing Address - Phone:972-809-8964
Mailing Address - Fax:
Practice Address - Street 1:4950 WADSWORTH DR APT 1019
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7824
Practice Address - Country:US
Practice Address - Phone:214-376-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider