Individual
DR. MARK P GOLDMAN
Active
Individual
DR. MARK P GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH. D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
22476
TX
103TC0700X
Clinical Psychologist
22476
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00H51R
BLUE CROSS
TX
01
—
098724001
CHIPS
TX
05
—
098724001
—
TX
Enumeration date
08/29/2006
Last updated
07/09/2010
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