Provider Demographics
NPI:1992853154
Name:GOFF, HEATHER WOODWORTH (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:WOODWORTH
Last Name:GOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:WOODWORTH
Other - Last Name:WICKLESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5326 HARRY HINES BLVD UTSW DEPT OF DERMATOLOGY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9069
Mailing Address - Country:US
Mailing Address - Phone:214-648-3493
Mailing Address - Fax:214-648-5553
Practice Address - Street 1:5939 HARRY HINES BLVD
Practice Address - Street 2:UT SOUTHWESTERN DERMATOLOGY CLINIC, SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390
Practice Address - Country:US
Practice Address - Phone:214-645-2400
Practice Address - Fax:214-645-2405
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8628207N00000X
IL036.116991207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology