Provider Demographics
NPI:1811953268
Name:GOFF, CAMILLE BRIDGET (MD)
Entity type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:BRIDGET
Last Name:GOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:BRIDGET
Other - Last Name:LANGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4801 WOODWAY #369W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056
Mailing Address - Country:US
Mailing Address - Phone:713-622-7060
Mailing Address - Fax:713-622-7093
Practice Address - Street 1:4801 WOODWAY #369W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056
Practice Address - Country:US
Practice Address - Phone:713-622-7060
Practice Address - Fax:713-622-7093
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6241208D00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Not Answered207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E08322Medicare UPIN
TX00F60WMedicare ID - Type Unspecified