Brooke Nichole Godino, P.T.
Individual provider Active NPI Physical Therapist · Pampa, TX
NPI 1073897682 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1073897682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1200317 (TX)
- Practice address
- 2545 Perryton Pkwy Ste 35
Pampa, TX 79065-2820 - Phone
- (806) 486-1697
- Fax
- (806) 412-5573
- NPI assigned
- Sep 30, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1200317 | TX | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1200317 | TX | Yes |
Addresses
Primary practice location
2545 Perryton Pkwy Ste 35
Pampa, TX 79065-2820
Mailing address
2525 N Grandview Ave
Suite 400
Odessa, TX 79761-1600
Phone (432) 550-4700
Other providers in Pampa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.