Patricia Whitehead Goen, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

H2407 Issued in TX

Practice address

1651 Rock Prairie Rd
#102
College Station, TX 77845-8652

Phone

(979) 693-7400

Fax

(979) 693-7446

NPI assigned

May 5, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Patricia Anne Whitehead Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brazos Valley Community Action Agency, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bryan, TX
  • NPI 1649265646
  NPD (past)
• Brazos Valley Community Action Agency, Inc.

  • Obstetrics Physician
  • College Station, TX
  • NPI 1811171580
  NPD (past)
• TCH Pediatric Associates, Inc

  • Pediatrics Physician
  • Sugar Land, TX
  • NPI 1861492654
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1053545079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 UNIVERSITY DR E",
            "address_2": "#100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402600",
            "telephone_number": "979-846-1100",
            "fax_number": "979-260-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 ROCK PRAIRIE RD",
            "address_2": "#102",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458652",
            "telephone_number": "979-693-7400",
            "fax_number": "979-693-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEN",
        "first_name": "PATRICIA",
        "middle_name": "WHITEHEAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H2407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187842301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CS CLINIC NPI",
            "identifier": "1275726853",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BVCAA NPI",
            "identifier": "1821185299",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "741715140",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "WHITEHEAD",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thuong Le Gist, O.D.
• D. Brent Glamann, M.D.
• Devan Neal Glass, MS, LAT, ATC
• Global Reach Family Eye Clinic, PLLC
• Denita Leshe Glogowski, CPNP-PC
• Paul Scott Goen, M D
• Brian Joseph Goerig, MD
• Ariel Brianna Gold, BCBA, LBA
• Adriana Goldberg
• Elizabeth Golden

• Pediatrics Physician in College Station, TX
• Providers in College Station, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.