Provider Demographics
NPI:1982081196
Name:GOODSON, KRISTI K (MD)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:K
Last Name:GOODSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:K
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-883-3113
Practice Address - Street 1:4100 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-3123
Practice Address - Country:US
Practice Address - Phone:945-204-4100
Practice Address - Fax:682-885-1903
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6491208M00000X, 208000000X
ARE11591208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics