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1306396759
CHARLES MICHAEL GOEDECKE
PEARLAND, TX
NPI
1306396759
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
Enumeration Date
2016-10-10
Last Update Date
2021-10-08
Business Address
Mr. CHARLES MICHAEL GOEDECKE LSA
16100 SH 288
PEARLAND, TX 77584
Phone number: 210-445-9456
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Mailing Address
Mr. CHARLES MICHAEL GOEDECKE LSA
1103 HAYLOFT LN
SAN ANTONIO, TX 78245-1456
Phone number: 210-445-9456
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