Provider Demographics
NPI:1225157761
Name:GOODWIN, FRANKIE C (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANKIE
Middle Name:C
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:SAN AUGUSTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75972-0699
Mailing Address - Country:US
Mailing Address - Phone:936-275-3626
Mailing Address - Fax:936-275-9932
Practice Address - Street 1:414 BAXTER ST
Practice Address - Street 2:
Practice Address - City:SAN AUGUSTINE
Practice Address - State:TX
Practice Address - Zip Code:75972-2608
Practice Address - Country:US
Practice Address - Phone:936-275-3626
Practice Address - Fax:936-275-9932
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14717101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor