Provider Demographics
NPI:1033645098
Name:GOOD NEIGHBOR CLINIC PLLC
Entity Type:Organization
Organization Name:GOOD NEIGHBOR CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, FNP
Authorized Official - Prefix:
Authorized Official - First Name:YUDIT
Authorized Official - Middle Name:
Authorized Official - Last Name:CONCEPCION-PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:ARPN
Authorized Official - Phone:832-767-4516
Mailing Address - Street 1:20263 SUNSET RANCH DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-0025
Mailing Address - Country:US
Mailing Address - Phone:832-767-4516
Mailing Address - Fax:832-767-4369
Practice Address - Street 1:7253 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-5801
Practice Address - Country:US
Practice Address - Phone:832-767-4516
Practice Address - Fax:832-767-4369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization