Individual
LINDA A GOODRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
251 MEDICAL CENTER BLVD, SUITE 300A, WEBSTER, TX 77598-4213
(281) 338-7693
(281) 338-8849
Mailing address
5124 HIDDEN BROOK LN, LEAGUE CITY, TX 77573-5781
(281) 338-7693
(281) 338-8849
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
J4827
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132474109
—
TX
05
—
176589301
—
TX
01
—
20-1567092
TAX IDENTIFICATION NUMBER
TX
Enumeration date
10/27/2005
Last updated
09/24/2007
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