Provider Demographics
NPI:1225243355
Name:GOSCIN, CHRISTOPHER PAUL (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:GOSCIN
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
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Mailing Address - Street 1:1820 PRESTON PARK BLVD
Mailing Address - Street 2:1825
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3656
Mailing Address - Country:US
Mailing Address - Phone:972-867-7862
Mailing Address - Fax:972-612-1623
Practice Address - Street 1:3901 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7738
Practice Address - Country:US
Practice Address - Phone:972-596-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM61542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM6154OtherTEXAS MEDICAL LICENSE
TX8K4166Medicare PIN