Provider Demographics
NPI:1164407615
Name:GODELL, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:GODELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-485-5878
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:7200 WYOMING SPRINGS DR STE 1300
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4306
Practice Address - Country:US
Practice Address - Phone:512-244-2273
Practice Address - Fax:512-244-3179
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2023-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM1113207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI34237Medicare UPIN
TX8D6995Medicare PIN
TX8D6996Medicare PIN