| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CHRISTIAN TAYLOR GOOD | 1952931180 | 2020-01-15 |
Christian Taylor Good is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1952931180. Registration indicates Christian Taylor Good is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Christian Taylor Good PA-C |
| Practice Office Address | 7777 FOREST LN STE B332 DALLAS, TX US |
| Practice Office Telephone | 9725667788 |
| Practice Office Fax | 9725668837 |
| Mailing Address | DEPT. 453, PO BOX 1000 MEMPHIS, TN 381480001 US |
| Business Telephone | 8285752625 |
| Business Fax | 8283502174 |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | PA14753
TX |
| 1952931180 | MEDICAID | TX | |
| 2N2420 | OTHER | TX | MEDICARE PTAN |