OrganizationActive
17th Medgrp-Goodfellow
NPI 1104805142 · Military/U.S. Coast Guard Outpatient Clinic/Center · Goodfellow Afb, TX
Provider details
- NPI number
- 1104805142
- Entity type
- Organization
- Primary specialty
- Military/U.S. Coast Guard Outpatient Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- 17th Medgrp-Goodfellow
- Authorized official
- Jen Lewandowski, Dha Ubo
Practice location
271 Fort Richardson Ave
Goodfellow Afb, TX 76908-4901
Phone: (325) 654-5974
Fax: (325) 654-3121
Mailing address
271 Fort Richardson Ave
Goodfellow Afb, TX 76908-4901
Registry dates
- Enumerated
- 2006-01-10
- Last updated
- 2025-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.