Individual
DANA MICHELLE GOGGANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 N LAMAR ST, FORT WORTH, TX 76196-0216
(817) 248-6209
Mailing address
PO BOX 732973, DALLAS, TX 75373-2973
(817) 702-2450
(817) 702-8445
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA11357
TX
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
PA11357
TX
Other
Enumeration date
07/28/2017
Last updated
01/29/2020
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