Good Health Clinic, PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

GOOD HEALTH CLINIC, PLLC

Practice address

505 Pleasanton Rd
San Antonio, TX 78214-1335

Phone

(210) 932-2565

Fax

(210) 932-2566

NPI assigned

Sep 6, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sylvia B Trevino, PA-C

Title

Physician Assistant/ Manager

Phone

(210) 422-2336

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572566400000",
    "number": "1609425115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PLEASANTON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782141335",
            "telephone_number": "210-422-2336",
            "fax_number": "210-932-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PLEASANTON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782141335",
            "telephone_number": "210-932-2565",
            "fax_number": "210-932-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD HEALTH CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-11-01",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT/ MANAGER",
        "authorized_official_telephone_number": "210-422-2336",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710038625",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.