Provider Demographics
NPI:1467247908
Name:GOODMAN, ALEXANDER CONSTANTINE (DO)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:CONSTANTINE
Last Name:GOODMAN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:CONSTANTINE
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:3601 4TH ST STOP 6211
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-6211
Mailing Address - Country:US
Mailing Address - Phone:806-743-2332
Mailing Address - Fax:806-743-4031
Practice Address - Street 1:3601 4TH ST STOP 6211
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-6211
Practice Address - Country:US
Practice Address - Phone:806-743-2332
Practice Address - Fax:806-743-4031
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program