CLYDE LEROY GOODMAN MD NPI 1801823083

NPI Information

  • NPI: 1801823083
  • Provider Name: CLYDE LEROY GOODMAN, MD
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • Address: 4840 BRYANT IRVIN CT.
    SUITE 104
    FORT WORTH, TX
    ZIP 76107
  • Phone: (817) 335-4549

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NPI Details

Clyde Leroy Goodman, MD is a general practice in Fort Worth, TX. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Clyde Leroy Goodman, MD NPI is 1801823083. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4840 BRYANT IRVIN CT.
SUITE 104
FORT WORTH, TX
ZIP 76107-680
Phone: (817) 335-4549
Fax: (817) 377-0970

The enumeration date for this NPI number is 6/26/2006 and was last updated on 10/4/2012.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeD7984TEXASYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B87881MEDICARE UPINTEXAS
2034680101MEDICAIDTEXAS
300L975MEDICARE ID-TYPE UNSPECIFIEDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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