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Contact Information

GOODSIDE HEALTH MEDICAL, PLLC
9910 INDIAN SCHOOL RD NE STE 204
ALBUQUERQUE, NM87112-2971
 Phone: 512-884-5190
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Clinic/Center

261Q00000X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Multi-Specialty

261QM1300X 70 Clinic or Group Practice
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for GOODSIDE HEALTH MEDICAL PLLC · (Female)

NPI Number 1033972716
Status Active
Credentials
Entity Individual
Enumeration date 02/05/2024
Last updated 06/13/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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