Goudreau, Jeffrey B
Goudreau, Jeffrey B is an individual health care provider with primary practice located at 5461 La Sierra Dr , Dallas TX 75231-4107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Goudreau, Jeffrey B can be contacted via phone (214) 692-8541.Contact Information
Primary practice address
5461 La Sierra Dr
Dallas TX 75231-4107
Phone: (214) 692-8541
Fax: (214) 242-1035
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | H2411 | Texas |
Profile Details
| NPI number | 1932179314 |
|---|---|
| LBN Legal business name | Goudreau, Jeffrey B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Jan 5th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932179314 | NPPES |
| Texas | MEDICAID | 043249401 |
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