Provider Demographics
NPI:1255320594
Name:GOALEY, THOMAS JOHN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:GOALEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 847408
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 HILLCREST MEDICAL BLVD
Practice Address - Street 2:TRAUMA SERVICES, HILLCREST BAPTIST MEDICAL CENTER
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8897
Practice Address - Country:US
Practice Address - Phone:254-202-5300
Practice Address - Fax:254-202-5349
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055420208600000X
GA0560622086S0127X
TXN30482086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA056062OtherMEDICAL LICENSE
VA0101055420OtherMEDICAL LICENSE
TXG0165380OtherTEXAS DEPARTMENT OF PUBLIC SAFETY
NE18256OtherMEDICAL LICENSE
TEMP 10APR2009OtherTEXAS MEDICAL BOARD
N3048OtherTX MED BOARD LICENSE
N3048OtherTX MED BOARD LICENSE