Provider Demographics
NPI:1326285933
Name:GOODWIN, ADOLPHINA
Entity type:Individual
Prefix:MS
First Name:ADOLPHINA
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 N CENTRAL EXPY STE 1700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-3783
Mailing Address - Country:US
Mailing Address - Phone:469-466-5557
Mailing Address - Fax:469-466-5558
Practice Address - Street 1:8080 N CENTRAL EXPY STE 1700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-3783
Practice Address - Country:US
Practice Address - Phone:469-466-5557
Practice Address - Fax:469-466-5558
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 261QR0200X, 335V00000X, 372600000X, 376J00000X, 372500000X, 374U00000X, 376J00000X
TX374U00000X
TX6250842085U0001X
IL13262859332471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No253Z00000XAgenciesIn Home Supportive Care
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No372500000XNursing Service Related ProvidersChore Provider