Individual
LON MICHAEL GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 GASTON AVE, SUITE 1205, DALLAS, TX 75246-1800
(214) 826-6021
(214) 823-9745
Mailing address
7515 GREENVILLE AVE, SUITE 900, DALLAS, TX 75231-3831
(214) 692-8262
(214) 823-9745
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D5392
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117256103
—
TX
01
—
340017091
RRMCR
TX
01
—
80416X
BCBS PROVIDER ID
—
Enumeration date
06/06/2006
Last updated
03/01/2013
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