Active NPI
Good4U Family Clinic Dallas Fort Worth Dfwpllc
- Family Nurse Practitioner
- Dallas, TX
National Provider Identifier
1629609060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- GOOD4U FAMILY CLINIC DALLAS FORT WORTH DFWPLLC
- Practice address
- 1417 N Cockrell Hill Rd Ste 101a
Dallas, TX 75211-1308 - Phone
- (214) 228-5447
- Fax
- (469) 778-0124
- NPI assigned
- Feb 3, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chibuzor Ngwakwe
- Title
- Manager
- Phone
- (214) 228-5447
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | |||
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
1417 N Cockrell Hill Rd Ste 101a
Dallas, TX 75211-1308
Mailing address
1417 N Cockrell Hill Rd Ste 106
Dallas, TX 75211-1430
Phone (214) 228-5447
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 803342054 | Other | TX | STATE OF TEXAS |
| 803342054 | Medicaid | TX |
Other names 1
- Good4u Family Clinic
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2241916 | Good4U Family Clinic DFW, PLLC | Certificate of waiver | Nov 2, 2027 |
National Provider Directory
National Provider DirectoryLocations
1417 N Cockrell Hill Rd
Ste 106
Dallas, TX 75211
1417 N Cockrell Hill Rd
Ste 101A
Dallas, TX 75211
Phone (469) 774-0124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580688000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1686873600000",
"number": "1629609060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1417 N COCKRELL HILL RD STE 106",
"city": "DALLAS",
"state": "TX",
"postal_code": "752111430",
"telephone_number": "214-228-5447",
"fax_number": "469-778-0124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1417 N COCKRELL HILL RD STE 101A",
"city": "DALLAS",
"state": "TX",
"postal_code": "752111308",
"telephone_number": "214-228-5447",
"fax_number": "469-778-0124"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOOD4U FAMILY CLINIC DALLAS FORT WORTH DFWPLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-02-03",
"last_updated": "2023-06-16",
"certification_date": "2023-06-16",
"status": "A",
"authorized_official_last_name": "NGWAKWE",
"authorized_official_first_name": "CHIBUZOR",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "214-228-5447"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF TEXAS",
"identifier": "803342054",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "803342054",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Good4u Family Clinic",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Good4u Family Clinic",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.