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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

NPI # 1033972716
LBN Legal business name GOODSIDE HEALTH MEDICAL, PLLC
Authorized official BRIAN WHITE - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/05/2024
Last updated 06/13/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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