AMANDA GWIN GOUDELOCK


Address: 3900 University Blvd, Tyler, TX 75799-6600
Phone: 9035667000

AMANDA GWIN GOUDELOCK (NPI# 1538644091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1538644091
Entity Type Individual
Full Name AMANDA GWIN GOUDELOCK
Practice Address 3900 University Blvd
Tyler
TX 75799-6600
Mailing Address 2943 Meadow Brook Trl
Tyler
TX 75701
Practice Telephone 9035667000
Mailing Telephone 3373787240
Enumeration Date 2018-10-01
Last Update Date 2018-10-01
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Office Location

Street Address 3900 UNIVERSITY BLVD
City TYLER
State TX
Zip Code 75799-6600

Providers in the same location

NPI Name Taxonomy Address Enumeration
1164406773 Gayle Pegler Varnell Nurse Practitioner 3900 University Blvd, Tyler, TX 75799-0001 2005-12-06
1063020501 Kacy Combest Counselor 3900 University Blvd, Tyler, TX 75799-6600 2020-07-21
1457991697 Cody Bryan Oliver Physical Medicine & Rehabilitation 3900 University Blvd, Tyler, TX 75799-6600 2020-01-15
1326523994 Naina Kishore Student in an Organized Health Care Education/Training Program 3900 University Blvd, Tyler, TX 75799-6600 2018-09-30
1891270922 Molly Laine Butcher Student in an Organized Health Care Education/Training Program 3900 University Blvd, Tyler, TX 75701-6601 2018-09-25
1679058747 Nathaniel Llave Student in an Organized Health Care Education/Training Program 3900 University Blvd, Tyler, TX 75799-6600 2018-09-25
1457836595 Splenderah Seyram Hodo Student in an Organized Health Care Education/Training Program 3900 University Blvd, Tyler, TX 75799-6600 2018-09-25
1447735584 Ryan Francis Student in an Organized Health Care Education/Training Program 3900 University Blvd, Tyler, TX 75799-6600 2018-09-25
1548744626 Fei Zhao Student in an Organized Health Care Education/Training Program 3900 University Blvd, Tyler, TX 75799-6600 2018-09-24
1922582097 Lindsey Nicole Spears Student in an Organized Health Care Education/Training Program 3900 University Blvd, Tyler, TX 75799-6600 2018-09-24
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659855476 Victoria Ezeh Student in an Organized Health Care Education/Training Program 3900 University Blvd # 128, Tyler, TX 75799-6600 2018-09-18
1619451069 Delight Onyejegbu Student in an Organized Health Care Education/Training Program 3900 University Blvd # 128, Tyler, TX 75799-6600 2018-09-21

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912512005 Courtney Yates Student in an Organized Health Care Education/Training Program 2920 Northlake Cv, Tyler, TX 75703-7033 2020-09-15
1033723895 Dylan Horinek Student in an Organized Health Care Education/Training Program 913 Beth Dr, Tyler, TX 75703-4813 2020-08-31
1326669060 Vijay Krishna Kuppurajan Student in an Organized Health Care Education/Training Program 11937u Hwy 271, Tyler, TX 75708-3154 2020-05-05
1427615699 Aiat Radwan Student in an Organized Health Care Education/Training Program 11937 U Highway 271, Attn: Kate Wells, Tyler, TX 75708 2019-05-23
1730663436 Michael Stephen Lowe Student in an Organized Health Care Education/Training Program 3201 Lexington Dr, Tyler, TX 75701-6663 2018-09-18
1659855476 Victoria Ezeh Student in an Organized Health Care Education/Training Program 3900 University Blvd # 128, Tyler, TX 75799-6600 2018-09-18
1972086999 Raul De Jesus Olmos Cervantes Student in an Organized Health Care Education/Training Program 1538 N Ross Ave, Tyler, TX 75702-4143 2018-09-14
1942783907 Deborah Adeyemo Student in an Organized Health Care Education/Training Program 2310 Haverhill Dr Apt 812, Tyler, TX 75707-4511 2018-09-14
1518491588 Azael Arizpe Jr. Student in an Organized Health Care Education/Training Program 1530 Lenora Ave, Tyler, TX 75702-2632 2017-04-17
1609224393 Nicole Goodman Student in an Organized Health Care Education/Training Program 13172 State Highway 64 E, Tyler, TX 75707-5340 2016-06-02
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Competitor

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City TYLER
Zip Code 75799

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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