Individual
TRE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5203 JUAN TABO BLVD NE STE 2B, ALBUQUERQUE, NM 87111-2691
(346) 323-1847
Mailing address
21341 RISING FAWN RD, PORTER, TX 77365-7632
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN322447
GA
Other
Enumeration date
04/24/2026
Last updated
04/24/2026
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