Provider Demographics
NPI:1427336254
Name:GODOY, HECTOR OMAR (DDS)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:OMAR
Last Name:GODOY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 TRAILHEAD PL
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-6018
Mailing Address - Country:US
Mailing Address - Phone:818-264-9199
Mailing Address - Fax:
Practice Address - Street 1:1410 N. LOOP 336 WEST
Practice Address - Street 2:SUITE A-CASTLE DENTAL
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3504
Practice Address - Country:US
Practice Address - Phone:936-441-0481
Practice Address - Fax:936-756-6783
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60533122300000X
LA6214122300000X
TX29456122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist