Individual
BRENDA LEATH GOINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
703 S FLEISHEL AVE # 5000, TYLER, TX 75701
(903) 606-7525
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP134960
TX
363LF0000X
Family Nurse Practitioner
20058
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128874
TN LICENSE
TN
05
—
389172303
—
TX
01
—
804055
MEDICARE
TX
01
—
P02245618
MEDICARE RAIL ROAD
TX
Enumeration date
10/27/2015
Last updated
08/01/2019
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