Provider Demographics
NPI:1285959031
Name:ORGOR, GODDY E
Entity type:Individual
Prefix:MR
First Name:GODDY
Middle Name:E
Last Name:ORGOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-4743
Mailing Address - Country:US
Mailing Address - Phone:713-446-6221
Mailing Address - Fax:713-893-6018
Practice Address - Street 1:3032 JACKSON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-4743
Practice Address - Country:US
Practice Address - Phone:713-446-6221
Practice Address - Fax:713-893-6018
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA554000171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications