Individual provider Active NPI

Edward Dulaney Goodman, PSYCHOLOGIST

  • Health Service Psychologist
  • Dallas, TX
National Provider Identifier
1467638007
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
21521 Issued in TX
Practice address
8350 Meadow Rd
Suite 272
Dallas, TX 75231-3768
Phone
(214) 535-8847
Fax
(972) 248-9063
NPI assigned
Jan 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X 21521 TX Primary

Addresses

Primary practice location

8350 Meadow Rd
Suite 272
Dallas, TX 75231-3768

Mailing address

18352 Dallas Pkwy
Suite 136-585
Dallas, TX 75287-5227
Phone (214) 535-8847

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

LicenseStateTypeSpecialty
21521TXMDHealth Service Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1467638007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18352 DALLAS PKWY",
            "address_2": "SUITE 136-585",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752875227",
            "telephone_number": "214-535-8847",
            "fax_number": "972-248-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 MEADOW RD",
            "address_2": "SUITE 272",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752313768",
            "telephone_number": "214-535-8847",
            "fax_number": "972-248-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "EDWARD",
        "middle_name": "DULANEY",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "TX",
            "license": "21521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.