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Individual

GREGG MARK GODFREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
246 S COMMERCIAL ST, ARANSAS PASS, TX 78336
(361) 758-6224
(361) 758-7749
Mailing address
246 S COMMERCIAL ST, ARANSAS PASS, TX 78336
(361) 758-6224
(361) 758-7749

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7289
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004HQ
BCBS
TX
05
001998601
TX
Enumeration date
10/02/2006
Last updated
02/14/2011
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