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Individual

MRS. AMANDA L GOODENOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
800 SCOTT AND WHITE DR, COLLEGE STATION, TX 77845-6440
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
AP142820
TX
363L00000X
Nurse Practitioner
AP142820
TX
363LF0000X
Family Nurse Practitioner
Primary
AP142820
TX

Other

Enumeration date
12/21/2019
Last updated
04/02/2025
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