| Doctor Name: | MR. JASON ERIC GOAD |
| NPI Number: | 1629336268 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, LPC |
| License Number: | 65036 |
| Business Practice Address: | 1715 Fm 1626 103 Manchaca, TX - 786523553 |
| Business Phone Number: | 5128207081 |
| Business Fax Number: | |
| Mailing Address: | 12421 Lowden Ln, A MANCHACA |
| State: | TX |
| Postal Code: | 786523621 |
| Phone Number: | 5128207081 |
| Fax Number: | |
| NPI Enumeration Date: | 05/02/2012 |
| NPI Last Update Date: | 05/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 65036 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |