GOOD4U FAMILY CLINIC DALLAS FORT WORTH DFWPLLC NPI 1629609060

NPI Information

NPI: 1629609060
Provider Name: GOOD4U FAMILY CLINIC DALLAS FORT WORTH DFWPLLC

Other Name: GOOD4U FAMILY CLINIC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 45D2241916

Address:
1417 N COCKRELL HILL RD STE 101A
DALLAS, TX
ZIP 75211
Phone: (214) 228-5447
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GOOD4U FAMILY CLINIC DALLAS FORT WORTH DFWPLLC is a family nurse practitioner in Dallas, TX. GOOD4U FAMILY CLINIC DALLAS FORT WORTH DFWPLLC NPI is 1629609060. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Good4u Family Clinic.

The provider's business location address is:

1417 N COCKRELL HILL RD STE 101A
DALLAS, TX
ZIP 75211-308
Phone: (214) 228-5447
Fax: (469) 778-0124

The provider's authorized official is Chibuzor Ngwakwe .
The authorized official title is Manager and has the following contact phone number (214) 228-5447.

The CLIA number assigned to this NPI record is 45D2241916 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/3/2020 and was last updated on 2/7/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RG0300X	Internal Medicine	Geriatric Medicine			No
2	363LF0000X	Nurse Practitioner	Family			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	803342054	OTHER	TEXAS	STATE OF TEXAS
2	803342054	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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