Individual
JERRY CLAY GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 BAYLOR PLZ, HOUSTON, TX 77030-3411
(713) 481-3544
(713) 432-0221
Mailing address
PO BOX 4698, HOUSTON, TX 77210-4698
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
E4357
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132441001
—
TX
05
—
132441010
—
TX
01
—
132441011
CSHCN
TX
Enumeration date
01/23/2006
Last updated
03/19/2009
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