Individual
ERICA LYNN GOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4400 WALNUT ST, GREENVILLE, TX 75401-5586
(872) 990-3455
Mailing address
5402 KAYWAY DR, GREENVILLE, TX 75402-6410
(903) 522-2933
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2122837
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083673818
—
TX
Enumeration date
09/08/2018
Last updated
09/08/2018
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