Provider Demographics
NPI:1275968588
Name:GOSS, THOMAS J (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:GOSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 TERRELL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-5569
Mailing Address - Country:US
Mailing Address - Phone:903-455-1073
Mailing Address - Fax:
Practice Address - Street 1:2824 TERRELL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-5569
Practice Address - Country:US
Practice Address - Phone:903-455-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12385111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor