DR. LARRY OMAR GOLDBECK (NPI# 1407971591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407971591 |
| Entity Type | Individual |
| Full Name | DR. LARRY OMAR GOLDBECK |
| Credential | M.D. |
| Practice Address |
29601 No Le Hace Dr Fair Oaks Ranch TX 78015-4518 |
| Practice Telephone | 8307554496 |
| Practice Fax Number | 8307554439 |
| Mailing Telephone | 8307554496 |
| Mailing Fax Number | 8307554439 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | C6952 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
29601 NO LE HACE DR |
| City | FAIR OAKS RANCH |
| State | TX |
| Zip Code | 78015-4518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356845242 | Samantha Royalty | Student in an Organized Health Care Education/Training Program | 31925 Deer Smt, Fair Oaks Ranch, TX 78015 | 2018-03-23 |
| 1124455985 | Charles Kennedy Jr. | Specialist | 8454 Northview Pass, Fair Oak Ranch, TX 78015 | 2013-10-10 |
| 1831448448 | Pamela Kelly Brennan | Registered Nurse | 208 Cibolo Ridge Trail, Boerne, TX 78015 | 2012-08-29 |
| 1508112558 | Tammy Marek Pllc | Counselor | 31525 Post Oak Trl, Fair Oaks Ranch, TX 78015 | 2012-07-27 |
| 1295001360 | Shanna Marie Miller | Speech-Language Pathologist | 8614 Carmel Rose, Boerne, TX 78015 | 2012-03-22 |
| 1184991184 | San Antonio Dental Center | Dentist | 8610 Napa Lndg, Boerne, TX 78015 | 2011-11-19 |
| 1386941227 | Priscilla Diane Diazdeleon | Speech-Language Pathologist | 8701 Cavalry, Fair Oaks Ranch, TX 78015 | 2011-02-11 |
| 1649586678 | Erica Janae Lunsford | Physician Assistant | 29602 Midnight Sun, Fair Oaks Ranch, TX 78015 | 2010-08-27 |
| 1053555953 | Ramon Cancino | Family Medicine | 25723 Old Fredericksburg, Boerne, TX 78015 | 2009-04-23 |
| 1194901744 | Fair Oaks Dental, Pa | Dentist | 9091 Fair Oaks Pkwy, Suite 304, Fair Oaks Ranch, TX 78015 | 2008-01-14 |
| Find all providers in zip 78015 | ||||
| Taxonomy Code | 204C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine, Sports Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124273222 | Potential Services Pllc | Neuromusculoskeletal Medicine, Sports Medicine | 8801 North Tarrant Parkway, North Richland Hills, TX 79182 | 2008-11-18 |
| 1730383324 | Norberto Alvarez Jr. | Neuromusculoskeletal Medicine, Sports Medicine | 1419 Clark Blvd, Laredo, TX 78040-3417 | 2007-06-14 |
| 1205950953 | Wright Wiley Singleton | Neuromusculoskeletal Medicine, Sports Medicine | 121 N E Loop 820, 100, Hurst, TX 76053 | 2007-03-19 |
| 1033260740 | Northwest Medical & Rehab Clinic Pa | Neuromusculoskeletal Medicine, Sports Medicine | 2829 W Northwest Hwy, Suite 904, Dallas, TX 75220-6219 | 2007-01-16 |
| 1063562635 | Nick J Patzakis | Neuromusculoskeletal Medicine, Sports Medicine | 9725 Homestead Rd, Houston, TX 77016-4403 | 2007-01-12 |
| 1174533889 | Richard F. Haenke | Neuromusculoskeletal Medicine, Sports Medicine | 2008 L Don Dodson Dr Ste 100, Bedford, TX 76021-1844 | 2006-08-08 |
| 1114931847 | Winifred Rene King | Neuromusculoskeletal Medicine, Sports Medicine | 15 Veilwood Cir, The Woodlands, TX 77382-4500 | 2006-07-28 |
| 1235155813 | Norbert Poquiz | Neuromusculoskeletal Medicine, Sports Medicine | 205 E Airport Fwy, Irving, TX 75062-6317 | 2006-07-15 |
| 1497790273 | Richard G Stoval | Neuromusculoskeletal Medicine, Sports Medicine | 1111 River Rd, Cuero, TX 77954-6641 | 2006-06-17 |
| 1154386829 | Jerett Aaron Zipin | Neuromusculoskeletal Medicine, Sports Medicine | 2100 Autumn Slate Dr Ste 150, Pflugerville, TX 78660 | 2006-04-18 |
| Find all providers with the same taxonomy | ||||
| City | FAIR OAKS RANCH |
| Zip Code | 78015 |
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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.