| Doctor Name: | POONAM GOSWAMI |
| NPI Number: | 1114357142 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 697255 |
| Business Practice Address: | 17510 W Grand Pkwy, Ste 420 Sugarland, TX - 774794308 |
| Business Phone Number: | 2812775200 |
| Business Fax Number: | 2812763442 |
| Mailing Address: | Po Box 911230, DALLAS |
| State: | TX |
| Postal Code: | 753911230 |
| Phone Number: | 9729978000 |
| Fax Number: | 9722342987 |
| NPI Enumeration Date: | 11/12/2013 |
| NPI Last Update Date: | 01/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 697255 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |