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Organization

MARK J GODAT MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAN SMITH GODAT (ADMINISTRATION)
(214) 893-8065
Entity
Organization

Contact information

Practice address
12201 MERIT DR STE 400, DALLAS, TX 75251-3117
(469) 840-4888
(469) 840-4886
Mailing address
7009 LAKE EDGE DR, DALLAS, TX 75230-2368
(214) 893-8065
(214) 696-9483

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1134281405
OBSTETRICS AND GYNECOLOBY
TX
01
1275198988
OBSTETRICS AND GYNECOLOGY
TX
Enumeration date
01/14/2025
Last updated
01/16/2025
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