Dudley Decatur Goulden III, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

E0476 Issued in TX

Practice address

11937 US Highway 271
Tyler, TX 75708-3154

Phone

(903) 877-7777

Fax

(903) 877-5838

NPI assigned

Oct 18, 2005

Last updated

Oct 10, 2016By the provider in NPPES

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

University of Florida College of Medicine, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Texas Health Science Center at Tyler-Facilty-PhysicianGroup PAC ID 4981699220, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dgoulden355243@ahs.direct-ci.com

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

• University of Texas Health Science Center at Tyler-Facility-Physician

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Tyler, TX
  • NPI 1063400778
  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at Tyler-Facilty-Physician

  dba UT Health East Texas Physicians Overton

  • Rural Health Clinic/Center
  • Overton, TX
  • NPI 1689496812
  NPD
• Greenwood Leflore Hospital

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1578595302
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295
  Care Compare affiliation

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1336138742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731912",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731912",
            "telephone_number": "903-877-7777",
            "fax_number": "903-877-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-877-7777",
            "fax_number": "903-877-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULDEN",
        "first_name": "DUDLEY",
        "middle_name": "DECATUR",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "E0476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102234501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Gose
• Goshen Home Health Services Inc
• Kaitlyn Suzanne Goss, APRN, FNP-C
• Savannah Goucher
• Jessica Gould, NP-C
• Matthew Bryan Gowen, AG-ACNP
• Tracy Goza, PHD
• William J Grabski, MD
• Grace Counceling Center
• Grace Hospice of East Texas, LLC.

• Cardiovascular Disease Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.