Provider Demographics
NPI:1083896427
Name:GOLDSTON, TONYA L (RN, BSN, CCRC, CMC)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:L
Last Name:GOLDSTON
Suffix:
Gender:F
Credentials:RN, BSN, CCRC, CMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 FOREST PARK RD
Mailing Address - Street 2:B9-100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9105
Mailing Address - Country:US
Mailing Address - Phone:214-648-6415
Mailing Address - Fax:214-648-4474
Practice Address - Street 1:6363 FOREST PARK RD
Practice Address - Street 2:B9-100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9105
Practice Address - Country:US
Practice Address - Phone:214-648-6415
Practice Address - Fax:214-648-4474
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX700308163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse