Mr. Charles Michael Goedecke, LSA
Mr. Charles Michael Goedecke, LSA is a Surgical Physician Assistant in Pearland, Texas. Practices as a sole proprietor and works from 2 locations. Registered with an NPI since 2016.
- In the registry since
- 2016
Practice location Address checks out
16100 Sh 288Pearland, TX 77584
Phone: (210) 445-9456
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 5410 West Loop South, Bellaire, TX 77401 — (210) 445-9456
Specialties & licences
| Surgical Physician Assistant (primary) | Taxonomy 363AS0400X |
|---|
Record details
| NPI number | 1306396759 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | LSA |
| Sole proprietor | Yes |
| NPI enumerated | October 10, 2016 |
| Last updated in NPPES | October 8, 2021 |
| Certification date | September 25, 2021 |
| Mailing address | 1103 Hayloft Ln, San Antonio, TX 78245-1456 |
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