NPI age
11 years
Enumerated 2014-06-19
● Active Type 2 · Organization
Subpart
17th Medgrp-Goodfellow
17th Medgrp-Goodfellow is 1 of 52 military/u.s. coast guard pharmacy organizations in Texas.
Primary specialty
Military/U.S. Coast Guard Pharmacy
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Morales
Chief Dha Pass
Last NPPES update
2025-06-13
Source: monthly bulk 2026-05
How this organization compares
Across 52 active military/u.s. coast guard pharmacy providers in Texas.
NPI age
11 years
↓ 8 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2014 → 2026
2014-06Enumerated in NPPES
2014
2026
Where they practice
Primary practice location
271 Fort Richardson Ave
Goodfellow Afb, TX 769084901
Mailing address
17 Medical Group, 271 Fort Richardson Ave.
Goodfellow Afb, TX 76908
Authorized official
Hector Morales
Chief Dha Pass
📞 2105366650
Individual providers at this organization
20 individual providers on file at this primary practice address.
- Matthew Bean Dentist NPI 1326545450
- Alexander Briones-Hernandez, PHARMD Pharmacist NPI 1255188694
- Brett Carr Dentist NPI 1497433759
- Pedro Colon Pharmacist NPI 1053582676
- Kristen Cooper, LCSW Social Worker NPI 1962210724
- Kelly Corbit, M-PAS, PA-C Physician Assistant NPI 1689121337
- Michael Roy De Jesus, DNP, APRN, FNP-C Nurse Practitioner NPI 1134647035
- Lindsay Denton, O.D. Optometrist NPI 1720278773
- Warren Dial, PA Physician Assistant NPI 1851486419
- Amanda Durbin, MA Psychologist NPI 1902479181
- Sonia Flick, LCSW-S, MCAP Social Worker NPI 1134679954
- Iveth Galvez Guzman, PA-C Physician Assistant NPI 1437460425
- James Glass, PA-C Physician Assistant NPI 1528703337
- Michelle Hanby, PH.D. Psychologist NPI 1659618338
- Logan Ledesma, DDS Dentist NPI 1588278808
- Devin Merritt, PHD Psychologist NPI 1568859650
- Thomas Montgomery, DDS Dentist NPI 1235687799
- Stravens Omwenga, CRNA Nurse Practitioner NPI 1548779234
- Morgan Peters, OD Optometrist NPI 1891543096
- Stacy Poindexter, PHARMD Pharmacist NPI 1487290912
Specialties
-
Military/U.S. Coast Guard Pharmacy PrimaryA Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 2146403 | PK |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
DoD GOODFELLOW ePhcy
Practice context
Multi-provider organization. 20 individual providers on file at this primary address.
Subpart of 17th Medgrp-Goodfellow.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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