Penny Goulden, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1202268 Issued in TX

Practice address

815 N Virginia St
Port Lavaca, TX 77979

Phone

(361) 551-2513

Fax

(361) 551-2528

NPI assigned

Jun 13, 2017

Last updated

Apr 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1750811733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12941 NORTH FWY STE 401",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770601243",
            "telephone_number": "832-253-1188",
            "fax_number": "832-253-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N VIRGINIA ST",
            "city": "PORT LAVACA",
            "state": "TX",
            "postal_code": "77979",
            "telephone_number": "361-551-2513",
            "fax_number": "361-551-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULDEN",
        "first_name": "PENNY",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1202268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Port Lavaca, TX
• Providers in Port Lavaca, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.