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Organization

G P GOODFRIED MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY PAUL GOODFRIED MD (ORTHOPEDIC SURGEON/OWNER)
(903) 597-5798
Entity
Organization

Contact information

Practice address
1905 S DONNYBROOK AVE, TYLER, TX 75701-4236
(903) 597-3140
(903) 595-5693
Mailing address
1905 S DONNYBROOK AVE, TYLER, TX 75701-4236
(903) 597-3140
(903) 595-5693

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
F1592
TX
363A00000X
Physician Assistant
Primary
PA00823
TX

Other

Enumeration date
05/01/2009
Last updated
12/22/2011
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