Basic Information
| Provider Information | |||||||||
| NPI: | 1326406281 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOEHRY | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | DOUGLAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 911 CENTRAL PKWY N | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782325052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104774965 | ||||||||
| FaxNumber: | 2104680682 | ||||||||
| Practice Location | |||||||||
| Address1: | 23960 KATY FWY | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774941339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104774965 | ||||||||
| FaxNumber: | 2104680682 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2016 | ||||||||
| LastUpdateDate: | 02/08/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 13139 | TX | Y | Chiropractic Providers | Chiropractor |
No ID Information.