Individual provider Active NPI

Glenda Marie Goodine, M.D.

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1992706212
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F2688 Issued in TX
Practice address
11452 Space Center Blvd
Houston, TX 77059
Phone
(832) 775-9800
Fax
(832) 775-9820
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F2688 TX Primary

Addresses

Primary practice location

11452 Space Center Blvd
Houston, TX 77059

Mailing address

3801 Vista Rd
Pasadena, TX 77504-2160
Phone (832) 775-9800

Other identifiers 1

IdentifierTypeStateIssuer
81Y721OtherTXBLUE CROSS BLUE SHIELD

Other names 1

  • Glenda Marie Murphy Other name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110127000382 TX Practitioner - Family Practice 2062691769 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F2688TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Family Medicine CurrentSince Jan 17, 2012 Accepting new patients
Ut Physicians CurrentSince Jan 17, 2012 Accepting new patients

Locations

6410 Fannin St
Ste 510
Houston, TX 77030
Phone (713) 500-5736

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

11452 Space Center Blvd
Houston, TX 77059
Phone (713) 486-6200

3801 Vista Rd
Pasadena, TX 77504
Phone (713) 844-2400

Interoperability endpoints

  • Direct secure messaging: ggoodine12096@direct.uth.org

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992706212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 VISTA RD",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775042160",
            "telephone_number": "832-775-9800",
            "fax_number": "832-775-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11452 SPACE CENTER BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77059",
            "telephone_number": "832-775-9800",
            "fax_number": "832-775-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODINE",
        "first_name": "GLENDA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F2688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81Y721",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDA",
            "last_name": "MURPHY",
            "middle_name": "MARIE",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.