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MR. CHARLES MICHAEL GOEDECKE LSA
NPI 1306396759
Physician Assistant - Surgical in Pearland, TX

Active since October 10, 2016
16100 SH 288, PEARLAND, TX 77584(210) 445-9456 Get Directions Write a Review

NPPES record last updated: October 8, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 8, 2021, Oct 10, 2016 (2 updates tracked since 2016).

About Mr. Charles Michael Goedecke Lsa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. CHARLES MICHAEL GOEDECKE LSA (NPI 1306396759) is an individual surgical provider in Pearland, Texas and active in the NPI registry since October 2016. He maintains a secondary practice location in Bellaire.

NPPES Registry Identity

NPI1306396759
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. CHARLES MICHAEL GOEDECKECredential: LSA
Location Address16100 SH 288Pearland, TX 77584
Mailing Address1103 Hayloft LnSan Antonio, TX 78245-1456 · (210) 445-9456
Phone(210) 445-9456
Sole ProprietorYes
Enumeration DateOctober 10, 2016
Last NPPES UpdateOctober 8, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2021
✔ NPI 1306396759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
16100 SH 288, Pearland, TX 77584
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Secondary Practice Location 1

Location 15410 WEST LOOP SOUTH, MEMORIAL HERMANN ORTHOPEDIC AND SPINE HOSPITALBELLAIRE, TX 77401 · Phone (210) 445-9456

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Goedecke's NPI number?

The NPI number for Charles Goedecke is 1306396759. It was assigned to this individual provider in the NPPES registry on October 10, 2016.

Where is Charles Goedecke located?

Charles Goedecke practices at 16100 Sh 288, Pearland, TX 77584. The listed phone number is (210) 445-9456.

What is Charles Goedecke's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Charles Goedecke was last updated on October 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.