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Organization
GOODSIDE HEALTH MEDICAL, PLLC
Active
Organization
GOODSIDE HEALTH MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WHITE CEO (MANAGER)
(214) 729-5600
Entity
Organization
Contact information
Practice address
777 CLEVELAND AVE SW STE 308, ATLANTA, GA 30315-7118
(281) 203-5006
Mailing address
1701 RIVER RUN STE 302, FORT WORTH, TX 76107-6547
(281) 203-5006
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/07/2022
Last updated
09/12/2023
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