Individual
MR. JESSE C GOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1103 S 31ST ST, TEMPLE, TX 76504-5214
(254) 771-5002
(254) 771-5008
Mailing address
6901 RIVER PARK CIR, FORT WORTH, TX 76116-8465
(817) 732-0800
(817) 596-5119
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
01313
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01313
TEXAS BOARD
TX
Enumeration date
01/02/2008
Last updated
06/20/2008
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