LARAINE LACEY GOESSLER P.A.-C NPI 1902919392

NPI Information

Laraine Lacey Goessler, P.A.-C is a medical physician assistant in Dallas, TX with 39 years of experience. Laraine Lacey Goessler, P.A.-C NPI is 1902919392. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3604 LIVE OAK ST STE 100
ATTN: LASHUNDA JOHNSON
DALLAS, TX
ZIP 75204-169
Phone: (214) 358-2300
Fax: (214) 366-6330

The NPI 1902919392 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/17/2006 and was last updated on 6/30/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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