Individual
MS. VIVIAN D GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
830 NORA LN, DESOTO, TX 75115-5462
(214) 455-1901
Mailing address
830 NORA LN, DESOTO, TX 75115-5462
(214) 455-1901
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
205639
TX
Other
Enumeration date
10/17/2021
Last updated
11/04/2025
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