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General NPI Number Information
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NPI Number | 1033645098
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Entity Type | Organization
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Legal Business Name | GOOD NEIGHBOR CLINIC PLLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 7253 BISSONNET ST
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City | HOUSTON
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State | TX
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Zip | 77074-5801
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Country | US
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Telephone | 832-767-4516
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Fax | 832-767-4369
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Provider Business Mailing Address
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Address Line | 20263 SUNSET RANCH DR
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City | KATY
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State | TX
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Zip | 77449-0025
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Country | US
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Telephone | 832-767-4516
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Fax | 832-767-4369
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Authorized Official
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Title or Position | OWNER, FNP
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Name | YUDIT CONCEPCION-PEREZ
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Credential | ARPN
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Telephone | 832-767-4516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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