Provider Demographics
NPI:1689754707
Name:GOODALE, SHARON (HIS)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:GOODALE
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 N NAVARRO ST STE L
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3937
Mailing Address - Country:US
Mailing Address - Phone:361-575-9911
Mailing Address - Fax:361-575-9977
Practice Address - Street 1:2806 N NAVARRO ST STE L
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3937
Practice Address - Country:US
Practice Address - Phone:361-575-9911
Practice Address - Fax:361-575-9977
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50652237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist