MR. DERRICK D. GOODWILL (NPI# 1821122243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821122243 |
| Entity Type | Individual |
| Full Name | MR. DERRICK D. GOODWILL |
| Credential | M.S., PA-C |
| Practice Address |
1935 Lakeside Plaza Dr Sugar Land TX 77479-4226 |
| Practice Telephone | 2814910413 |
| Mailing Telephone | 2814910413 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2011-09-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA04820 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1935 LAKESIDE PLAZA DR |
| City | SUGAR LAND |
| State | TX |
| Zip Code | 77479-4226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316556814 | Yewtree Assisted Living & Memory Care | Assisted Living Facility | 2100 Village Court, Sugar Land, TX 77479 | 2020-07-30 |
| 1386253235 | Sheeja Mathews Tharappel | Registered Nurse | 3819 Pearl Pass Lane, Sugar Land, TX 77479 | 2020-07-27 |
| 1417579004 | Esperanza Velasquez | Social Worker | 806 Heather Park Ct., Sugar Land, TX 77479 | 2020-05-18 |
| 1730717927 | Ajay K Bhora Md Pa | Internal Medicine | 2647 Cordes Drive, Sugar Land, TX 77479 | 2020-04-01 |
| 1790316693 | Anuki Rukshani Weerakoon-wijeratne | Pharmacy Technician | 16605 Southwest Fwy Mob3, Ste 100, Sugar Land, TX 77479 | 2020-01-29 |
| 1952957961 | Nicole Marie Pon | Nurse Practitioner | Houston Methodist Sugar Land Hospital, 16655 Southwest Fwy, Sugar Land, TX 77479 | 2019-08-15 |
| 1083279731 | Phoenix Solutions Pllc | Clinic/Center | 815 Flagstone Pass Ct, Sugar Land, TX 77479 | 2019-05-08 |
| 1538722335 | Daniel Max & Marc Andrea LLC | Optometrist | 13582 University Blvd #600, Sugar Land, TX 77479 | 2019-04-17 |
| 1962968727 | Dentists of Riverstone, PC | Dentist | 18802 University Blvd., Ste. 110, Sugar Land, TX 77479 | 2019-02-18 |
| 1578048104 | Sonam Dhuka | Nurse Practitioner | 16605 Sw Freeway, Suite 115, Sugarland Texas 77479, Sugar Land, TX 77479 | 2018-09-28 |
| Find all providers in zip 77479 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134770761 | Amber Fatima | Physician Assistant | 9614 Abigail Dr, Sugar Land, TX 77498-7509 | 2019-09-25 |
| 1346717204 | Tanaya Pattnaik | Physician Assistant | 8739 Rippling Water Dr, Sugar Land, TX 77479-6976 | 2018-10-30 |
| 1801239785 | Christine Luciani Gilbert | Physician Assistant | 4690 Sweetwater Blvd Ste 200, Sugar Land, TX 77479-3478 | 2013-04-10 |
| 1679859268 | Fernando Carlos Basail | Physician Assistant | 3102 Waters Way Dr, Sugar Land, TX 77478-4471 | 2011-10-26 |
| 1821327586 | Madhavi Samanthapudi Raju | Physician Assistant | 19875 Southwest Freeway, Suite 100, Sugar Land, TX 77479 | 2009-12-09 |
| 1598996647 | Erica Janel Young | Physician Assistant | 4419 Treasure Trail, Sugar Land, TX 77479-2010 | 2009-08-06 |
| 1558487363 | Jill D. Mcgraw | Physician Assistant | 1327 Lake Pointe Pkwy Ste 416, Sugar Land, TX 77478-4095 | 2007-03-22 |
| 1952310849 | Stephen Choy | Physician Assistant | 13020 Dairy Ashford Rd Ste 100, Sugar Land, TX 77478-3151 | 2006-08-07 |
| 1285265504 | Cassandra Alyse Rivera | Physician Assistant | 1 Sugar Creek Center Blvd Ste 618, Sugar Land, TX 77478-3540 | 2020-01-27 |
| 1588205660 | Gregory D Ferguson | Physician Assistant | 4820 Sweetwater Blvd, Sugar Land, TX 77479-3153 | 2019-09-30 |
| Find all providers in SUGAR LAND | ||||
| City | SUGAR LAND |
| Zip Code | 77479 |
Please comment or provide details below to improve the information on MR. DERRICK D. GOODWILL.
| 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.