Provider Demographics
NPI:1235443219
Name:JOEL H. GOFFMAN, M.D., P.A.
Entity Type:Organization
Organization Name:JOEL H. GOFFMAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:GOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-467-0990
Mailing Address - Street 1:9090 GAYLORD DR STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2948
Mailing Address - Country:US
Mailing Address - Phone:713-467-0990
Mailing Address - Fax:713-464-6989
Practice Address - Street 1:9090 GAYLORD DR STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2948
Practice Address - Country:US
Practice Address - Phone:713-467-0990
Practice Address - Fax:713-464-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9146207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB23041Medicare UPIN