Provider Demographics
NPI:1932600855
Name:GOODSON, SARAH ANNE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANNE
Last Name:GOODSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14100 SAN PEDRO AVE STE 412
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2009
Mailing Address - Country:US
Mailing Address - Phone:210-281-8669
Mailing Address - Fax:210-314-5044
Practice Address - Street 1:11398 BANDERA RD STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-6827
Practice Address - Country:US
Practice Address - Phone:210-281-8669
Practice Address - Fax:210-314-5044
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily