Provider Demographics
NPI:1447239447
Name:GOODMAN, LINDA DEE (PA-C, MPAJ)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:DEE
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:PA-C, MPAJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 760488
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-0488
Mailing Address - Country:US
Mailing Address - Phone:210-523-9933
Mailing Address - Fax:210-647-0242
Practice Address - Street 1:1911 ROGERS RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4614
Practice Address - Country:US
Practice Address - Phone:210-523-9933
Practice Address - Fax:210-647-0242
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
8C6657Medicare ID - Type Unspecified
Q25839Medicare UPIN