Individual
ELIZABETH A. GOEDECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2200 BERGQUIST DR, SUITE 1, LACKLAND A F B, TX 78236-9907
(210) 292-3871
Mailing address
145 LAMONT AVE, SAN ANTONIO, TX 78209-3751
(210) 273-0559
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05062
TX
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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