Provider Demographics
NPI:1093855363
Name:GOOD HABITS MEDICINE
Entity Type:Organization
Organization Name:GOOD HABITS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENATO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ATENCIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-968-3300
Mailing Address - Street 1:311 S MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6015
Mailing Address - Country:US
Mailing Address - Phone:956-968-3300
Mailing Address - Fax:956-968-4700
Practice Address - Street 1:311 S MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6015
Practice Address - Country:US
Practice Address - Phone:956-968-3300
Practice Address - Fax:956-968-4700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty