Waterloo Med Co

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

K5965 Issued in TX

Legal business name

WATERLOO MED CO

Practice address

6800 W Gate Blvd
Ste 132-309
Austin, TX 78745-4883

Phone

(512) 767-2074

NPI assigned

Oct 23, 2010

Organization subpart

No

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

Authorized official

Name

Jeffrey GoodloeNPI 1285610428

Title

Ceo

Phone

(512) 767-2074

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey M Goodloe, M.D.

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1285610428
  NPD (past) Authorized official

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

{
    "created_epoch": "1287792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1588964662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 W GATE BLVD",
            "address_2": "STE 132-309",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787454883",
            "telephone_number": "512-767-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 W GATE BLVD",
            "address_2": "STE 132-309",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787454883",
            "telephone_number": "512-767-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERLOO MED CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-23",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "GOODLOE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-767-2074"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K5965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Water Leaf Surgery Center, LTD
• Waterfalls Medical Clinic Inc.
• Waterloo Counseling Center, Inc.
• Waterloo Family Practice, PLLC
• Waterloo Imaging LLC
• Waterloo Medical
• Waterloo Residential Services Inc.
• Amanda Waterman, M.D.
• Alexandria D Waters
• Hunter Waters

• Emergency Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; 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.