Individual
JUAN GODINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2010 BEN MERRITT DR UNIT A, DECATUR, TX 76234-3853
(940) 626-2300
(940) 626-2315
Mailing address
7415 LAS COLINAS BLVD STE 100, IRVING, TX 75063-7569
(214) 379-2722
(972) 869-3875
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
220850
MA
2085R0001X
Radiation Oncology Physician
CDR.0001781
CO
2085R0001X
Radiation Oncology Physician
ME70845
FL
2085R0001X
Radiation Oncology Physician
Primary
N6314
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
251521
AVMED
FL
05
—
258329100
—
FL
05
—
364030201
—
TX
01
—
44853
BCBSFL
FL
01
—
P00862529
RR MEDICARE
FL
01
—
P01875021
RAILROAD
TX
Enumeration date
04/28/2006
Last updated
06/14/2022
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