Provider Demographics
NPI:1164502092
Name:GOFF, KAREN O (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:O
Last Name:GOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6163
Mailing Address - Fax:682-885-7347
Practice Address - Street 1:3304 COLORADO BLVD STE 101
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6872
Practice Address - Country:US
Practice Address - Phone:940-565-1510
Practice Address - Fax:940-243-0607
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0355208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U87ZOtherBCBSTX GRP PIN
TXGOFKG52026OtherCCHIP PIN
TX413815OtherPHCS PIN
TX86460GOtherBCBSTX IND PIN
TX1068004OtherFIRSTHEALTH PIN
TX1756582OtherUHC PIN
TX5810474OtherAETNA PIN
TX5094701OtherCIGNA PIN