Provider Demographics
NPI:1841840915
Name:GOOCH, CHRISTINE C
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:C
Last Name:GOOCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14601 BELLAIRE BLVD UNIT 214
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-2505
Mailing Address - Country:US
Mailing Address - Phone:832-384-6349
Mailing Address - Fax:
Practice Address - Street 1:8145 HIGHWAY 6 S STE 130
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5740
Practice Address - Country:US
Practice Address - Phone:832-328-4104
Practice Address - Fax:832-328-4162
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service