17TH MEDICAL GROUP – NPI #1235490574
Clinic/Center

17TH MEDICAL GROUP is an AHC clinic located in GOODFELLOW AFB, TX. NPPES has assigned the NPI number 1235490574 to 17TH MEDICAL GROUP on June 04, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QH0100X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Health Service

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 17TH MEDICAL GROUP below.

NPI Profile for
17TH MEDICAL GROUP

NPI Number
1235490574
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
17TH MEDICAL GROUP
Primary location
271 FORT RICHARDSON AVE
GOODFELLOW AFB, TX 76908-4901
Phone: (325) 654-5238 Fax:
Mailing address
1407 GREGORY DR
SAN ANGELO, TX 76905-4213
Phone: Fax:
Organization Subpart
No
Authorized Official
JAMES FORREST
COLONEL
Phone: (325) 654-3075
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QH0100X
- Clinic/Center / Health Service (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.