Individual provider · Type 1 NPI

Charles Michael Goedecke, LSA

Surgical Physician Assistant · Pearland, TX

NPI number 1306396759 Active

Practice location

16100 Sh 288
Pearland, TX 77584

Call (210) 445-9456 Map

Mailing address

1103 Hayloft Ln
San Antonio, TX 78245-1456

Other practice locations

  • 5410 West Loop South, Memorial Hermann Orthopedic And Spine Hospital, Bellaire, TX 77401 · (210) 445-9456

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1306396759

Charles Michael Goedecke, LSA's National Provider Identifier is 1306396759, issued on Oct 10, 2016. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Pearland, TX. The record was last updated on Oct 8, 2021.