Provider Demographics
NPI:1063641389
Name:GOODMAN, STEVEN CHAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CHAD
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 1040
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7310
Mailing Address - Country:US
Mailing Address - Phone:713-626-8343
Mailing Address - Fax:
Practice Address - Street 1:4126 SOUTHWEST FWY
Practice Address - Street 2:SUITE 1040
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7310
Practice Address - Country:US
Practice Address - Phone:713-626-8343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247421223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics