17th Medgrp-Goodfellow

Organization Military/U.S. Coast Guard Outpatient Clinic/Center · NPI 1104805142

17th Medgrp-Goodfellow is a Military/U.S. Coast Guard Outpatient Clinic/Center in Goodfellow AFB, Texas. Licensed in Texas. Registered with an NPI since 2006.

Licensed in: TX
In the registry since: 2006
Specialties on file: 3

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Practice location Address checks out

271 Fort Richardson Ave
Goodfellow AFB, TX 76908-4901
Phone: (325) 654-5974
Fax: (325) 654-3121

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Military/U.S. Coast Guard Outpatient Clinic/Center (primary)	Taxonomy 261QM1100X (TX)
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center	Taxonomy 261QM1101X
Military/U.S. Coast Guard Pharmacy	Taxonomy 332000000X

Record details

NPI number	1104805142
Entity type	Organization (Type 2)
Organization subpart	Yes
Parent organization	17th Medgrp-Goodfellow
Authorized official	Jen Lewandowski — Dha Ubo · (703) 817-4030
NPI enumerated	January 10, 2006
Last updated in NPPES	June 17, 2025
Certification date	June 17, 2025
Mailing address	271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901