| Goodside Health Medical, Pllc | |
|
777 Cleveland Ave Sw Ste 308 Atlanta GA 30315-7118 | |
| (281) 203-5006 | |
| Not Available |
| Full Name | Goodside Health Medical, Pllc |
|---|---|
| Speciality | Pediatrics |
| Location | 777 Cleveland Ave Sw Ste 308, Atlanta, Georgia |
| Authorized Official Name and Position | Brian White (MANAGER) |
| Authorized Official Contact | 2147295600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goodside Health Medical, Pllc 1701 River Run Ste 302 Fort Worth TX 76107-6547 Ph: (281) 203-5006 | Goodside Health Medical, Pllc 777 Cleveland Ave Sw Ste 308 Atlanta GA 30315-7118 Ph: (281) 203-5006 |
| NPI Number | 1437888377 |
|---|---|
| Provider Enumeration Date | 06/07/2022 |
| Last Update Date | 09/12/2023 |
| Medicare PECOS PAC ID | 1557745478 |
|---|---|
| Medicare Enrollment ID | O20230407000336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437888377 | NPI | - | NPPES |
| Provider Name | Gerardo Reyes |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194767954 PECOS PAC ID: 1153429576 Enrollment ID: I20070608000352 |
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