Basic Information
Provider Information
NPI: 1366888950
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GOODSON
FirstName: ERIKA
MiddleName: BRITO
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6769 LAKE WOODLANDS DR STE E
Address2:  
City: THE WOODLANDS
State: TX
PostalCode: 773822771
CountryCode: US
TelephoneNumber: 2812101200
FaxNumber: 2812101210
Practice Location
Address1: 6769 LAKE WOODLANDS DR STE E
Address2:  
City: THE WOODLANDS
State: TX
PostalCode: 773822771
CountryCode: US
TelephoneNumber: 2812101200
FaxNumber: 2812101210
Other Information
ProviderEnumerationDate: 05/22/2013
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XQ1952TXY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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