Provider Demographics
NPI:1023844826
Name:GOOD SHEPHERD PRIMARY HEALTH CARE LLC
Entity type:Organization
Organization Name:GOOD SHEPHERD PRIMARY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MACARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-262-7445
Mailing Address - Street 1:7981 MILE 17 N
Mailing Address - Street 2:
Mailing Address - City:EDCOUCH
Mailing Address - State:TX
Mailing Address - Zip Code:78538-2096
Mailing Address - Country:US
Mailing Address - Phone:956-262-7445
Mailing Address - Fax:956-262-0008
Practice Address - Street 1:7981 MILE 17 N
Practice Address - Street 2:
Practice Address - City:EDCOUCH
Practice Address - State:TX
Practice Address - Zip Code:78538-2096
Practice Address - Country:US
Practice Address - Phone:956-262-7445
Practice Address - Fax:956-262-0008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD SHEPHERD PRIMARY HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-10
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative MedicineGroup - Multi-Specialty