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Individual

DR. IAN BENJAMIN GOODRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNP-A, CRNA

Contact information

Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 742-8387
Mailing address
5473 BLAIR RD STE 100 PMB 760375, DALLAS, TX 75231-4227
(281) 908-1179

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
953739
TX

Other

Enumeration date
12/25/2023
Last updated
02/28/2024
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