Provider Demographics
NPI:1407082357
Name:GOEN, MARIA E (LSA)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:E
Last Name:GOEN
Suffix:
Gender:F
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5524
Mailing Address - Country:US
Mailing Address - Phone:713-898-5449
Mailing Address - Fax:832-681-9050
Practice Address - Street 1:3808 LAKE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5524
Practice Address - Country:US
Practice Address - Phone:713-850-0870
Practice Address - Fax:832-681-9050
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00389246ZC0007X, 246ZS0410X, 246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist