Active NPI
Hogan Mackenzie Goodson
- Student in an Organized Health Care Education/Training Program
- Detroit, TX
National Provider Identifier
1245748482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 38084403
- Practice address
- 1543 FM 1502
Detroit, TX 75416 - Phone
- (903) 495-3968
- NPI assigned
- Jan 22, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 38084403 | TX | Primary |
Addresses
Primary practice location
1543 FM 1502
Detroit, TX 75416
Mailing address
PO Box 347
Blossom, TX 75416-0347
Phone (903) 495-3968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38084403 | TX | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516579200000",
"number": "1245748482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 347",
"city": "BLOSSOM",
"state": "TX",
"postal_code": "754160347",
"telephone_number": "903-495-3968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1543 FM 1502",
"city": "DETROIT",
"state": "TX",
"postal_code": "75416",
"telephone_number": "903-495-3968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODSON",
"first_name": "HOGAN",
"middle_name": "MACKENZIE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-22",
"last_updated": "2018-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "38084403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.