Provider Demographics
NPI:1497827257
Name:GOLDBERG, SEYMOUR H (MD)
Entity Type:Individual
Prefix:DR
First Name:SEYMOUR
Middle Name:H
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6102 VICKI JOHN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-5740
Mailing Address - Country:US
Mailing Address - Phone:713-777-6237
Mailing Address - Fax:
Practice Address - Street 1:7900 FANNIN ST STE 3250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2935
Practice Address - Country:US
Practice Address - Phone:713-790-9800
Practice Address - Fax:713-790-0846
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG41232080A0000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Not Answered2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4900903006OtherCIGNA
TX000005710529OtherUNITED HEALTHCARE
TX685602OtherAETNA
TX127413OtherAETNA
TX00AW43OtherBLUE CROSS BLUE SHIELD
TX127413OtherAETNA