Kenneth a Goldberg MD PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

F4843 Issued in TX

Legal business name

KENNETH A GOLDBERG MD PA

Practice address

541 W Main St
Suite150
Lewisville, TX 75057-3628

Phone

(972) 420-8500

Fax

(972) 221-6302

NPI assigned

Dec 26, 2012

Organization subpart

No

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

Authorized official

Name

Tonjia Roan

Title

Office Manager

Phone

(972) 420-8500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1144566985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 W MAIN ST",
            "address_2": "SUITE150",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573628",
            "telephone_number": "972-420-8500",
            "fax_number": "972-221-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 W MAIN ST",
            "address_2": "SUITE150",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573628",
            "telephone_number": "972-420-8500",
            "fax_number": "972-221-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH A GOLDBERG MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-26",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "ROAN",
        "authorized_official_first_name": "TONJIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "972-420-8500"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "TX",
            "license": "F4843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Urology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.