ELIZABETH A. GOEDECKE (NPI# 1265589436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265589436 |
Entity Type | Individual |
Full Name | ELIZABETH A. GOEDECKE |
Credential | PA-C |
Practice Address |
2200 Bergquist Dr Suite 1 Lackland A F B TX 78236-9907 |
Mailing Address |
145 Lamont Ave San Antonio TX 78209-3751 |
Practice Telephone | 2102923871 |
Mailing Telephone | 2102730559 |
Enumeration Date | 2007-01-03 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | PA05062 | TX | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2200 BERGQUIST DR SUITE 1 |
City | LACKLAND A F B |
State | TX |
Zip Code | 78236-9907 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235139494 | Kathryn Joyce | Nurse Practitioner | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2005-07-28 |
1619219789 | Jodie K Timberlake | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Willford Hall Ambulatory Surgical Center, Lackland A F B, TX 78236-9907 | 2013-03-26 |
1467798884 | James W Parry | Military Health Care Provider | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-12-13 |
1093065252 | Brittany Mccright | Physical Therapist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-09-14 |
1003177593 | Danielle Kusserow Bersabe | Internal Medicine | 2200 Bergquist Dr, Wilford Hall Ambulatory Surgical Center, Lackland A F B, TX 78236-9907 | 2012-05-31 |
1114206570 | Ana Ugues Aleman | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2011-08-16 |
1902192743 | Ashley Noelle Franz | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Wilford Hall Medical Center, Lackland A F B, TX 78236-9907 | 2011-06-20 |
1699067694 | Kristen Kann | Emergency Medicine | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2011-05-09 |
1891090577 | Evan Gregory Smith | Physician Assistant | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2011-01-11 |
1295041853 | Santos Michael Rivera II | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2010-08-20 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
Find all providers in zip 78236 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467891366 | Samantha Luanne Guy | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-06-24 |
1881935112 | J T Floyd | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-03-12 |
1356480248 | Carol Forrest | Physician Assistant | 1515 Truemper St, Lackland A F B, TX 78236-5583 | 2007-02-06 |
1366549222 | Jason Ray Rogers | Physician Assistant | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2006-09-20 |
1760456917 | Roy Robert Estrada | Physician Assistant | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2006-02-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932700440 | Heather Weir | Physician Assistant | 7331 Gaston Ave Ste 180, Dallas, TX 75214-4131 | 2020-11-03 |
1366042335 | Mary Elizabeth Arnold | Physician Assistant | 12455 Longmire Lakeview, Conroe, TX 77304-1087 | 2020-10-29 |
1396345443 | Avery Rhodes Schwartz | Physician Assistant | 2206 Latexo Dr, Houston, TX 77018-1717 | 2020-10-28 |
1174123111 | Stephanie Rae Moench | Physician Assistant | 1704 Enfield Rd Apt 102, Austin, TX 78703-3348 | 2020-10-28 |
1811596927 | Emily Lau | Physician Assistant | 3848 N Tarrant Pkwy Ste 120, Fort Worth, TX 76244-5422 | 2020-10-20 |
1720686116 | Richard Magana | Physician Assistant | 1651 Ridgemar Dr, Grand Prairie, TX 75051-3340 | 2020-10-16 |
1295333532 | Victoria Jane Campbell | Physician Assistant | 4412 Young Dr, Carrollton, TX 75010-1144 | 2020-10-09 |
1134726763 | Barbara Elizabeth Montoya | Physician Assistant | 3309 Nottingham Dr, Laredo, TX 78043-1202 | 2020-10-06 |
1376140400 | April L Thepsoumane | Physician Assistant | 4808 Hale Dr, Austin, TX 78749-3711 | 2020-10-01 |
1881291938 | Christine Nicole Nott | Physician Assistant | 13325 Hargrave Rd # 240, Houston, TX 77070-4539 | 2020-10-01 |
Find all providers with the same taxonomy |
City | LACKLAND A F B |
Zip Code | 78236 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.