Provider Demographics
NPI:1205938560
Name:GOODWIN, DAVID JAMES JR (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:GOODWIN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12171 W PARMER LN
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7361
Mailing Address - Country:US
Mailing Address - Phone:512-588-1501
Mailing Address - Fax:512-588-1502
Practice Address - Street 1:12171 W PARMER LN
Practice Address - Street 2:SUITE 203
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7361
Practice Address - Country:US
Practice Address - Phone:512-588-1501
Practice Address - Fax:512-588-1502
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO5817111N00000X
TX11476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor