Organization
GOOD DOCTOR CLINIC AND URGENT CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDATH RANNULU MD (MD)
(972) 296-9930
Entity
Organization
Contact information
Practice address
4759 SOUTH FWY STE A, FT WORTH, TX 76115-3655
(817) 923-7374
Mailing address
777 E WHEATLAND RD STE 108, DUNCANVILLE, TX 75116-4918
(972) 296-9930
(972) 709-1340
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/05/2017
Last updated
04/27/2020
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