SEO Case Study: Ranked Local 3-Pack in 4 Months for a Clinic in Houston
In 2025, a clinic in Houston partnered with Goforaeo to break into the Google local 3 pack for high intent service keywords and convert that visibility into calls and direction requests. The clinic name is anonymized due to an NDA, and the numbers below come from Google Business Profile insights, local rank tracking, GA4, Google Search Console, and call tracking for the dates listed.
Snapshot of Results
Timeframe: May 2, 2025 to September 2, 2025
Location: Houston, Texas
Before vs after results:
- Local 3 pack placements: 0 to consistent top 3 for priority terms
- Tracked keywords in top 3 (maps): 0 to 9 service keywords
- Tracked keywords in top 10 (maps): 3 to 18 service keywords
- GBP impressions: 21,400 to 78,900 per month
- Discovery searches: 1,900 to 6,800 per month
- GBP actions: 360 to 1,420 per month (calls, directions, website clicks)
- Calls from Maps + organic: 52 to 176 per month
Context and Starting Point
Houston is a competitive local market where map rankings are heavily influenced by service relevance, listing completeness, trust consistency, and engagement. The clinic had strong services and good patient experience, but it wasn’t consistently showing for non branded discovery searches. Categories and services were not fully built out, local citations had inconsistencies, and the website didn’t strongly reinforce the same service intent.
To reach the 3 pack in four months, we focused on the levers that move Maps visibility fastest: GBP rebuild, citation cleanup, local content reinforcement, review cadence, and engagement consistency.
Baseline Setup and Measurement
We cleaned tracking and created a reliable baseline before changes. This ensured every movement in impressions, actions, and rankings could be tied back to real improvements.
What we set up
- GBP insights tracking for impressions, discovery searches, and actions
- Local rank tracking for priority Houston service keywords (grid + zip level)
- GA4 events for calls, forms, and appointment clicks
- Call tracking to separate listing calls from website calls where possible
- Looker Studio reporting with weekly notes and change dates
Diagnosis: Why the Clinic Wasn’t in the 3 Pack
We audited GBP, citations, and on site local signals. The clinic was credible, but Google didn’t have strong enough structured signals to confidently rank it in the top 3.
Key issues found
- Categories were too narrow for actual services offered
- Service list was incomplete and lacked descriptions
- Photos were outdated, and posting cadence was inconsistent
- NAP and hours inconsistencies existed across directories
- A couple duplicate listings were splitting authority
- Website service pages were thin and didn’t map cleanly to Houston intent searches
- Internal linking did not push authority into the highest value services
- Review velocity was inconsistent and responses lacked a cadence
Strategy Overview
We used a three lever local system so growth compounded and rankings stabilized.
Workstreams
- Expand relevance and query coverage in GBP
- Improve trust consistency via citations and duplicates cleanup
- Increase engagement through posts, photos, reviews, and better conversion flow
Google Business Profile Rebuild
We treated GBP like the main landing page. The goal was to increase query coverage and improve actions once users found the listing.
What we changed in GBP
- Reworked primary and secondary categories based on demand and competitors
- Expanded services and added short descriptions using search language
- Improved business description, attributes, and appointment links
- Added UTM tracked website and booking URLs
- Started weekly posts (availability, insurance, seasonal topics, service highlights)
- Implemented a photo plan with exterior, interior, staff, and service context images
- Added Q and A content covering common booking questions
Citation Cleanup and Trust Consistency
In competitive markets, small inconsistencies can block 3 pack visibility. We cleaned the highest impact sources first and removed duplicates.
What we fixed
- Standardized NAP format and phone formatting everywhere
- Updated hours, website URL, and appointment links on major platforms
- Removed duplicate listings and merged profiles where possible
- Built or updated niche healthcare citations where competitors were present
Website Reinforcement for Map Rankings
Map rankings improve when the website confirms the same services and local relevance. We strengthened service pages and built supporting content that reinforced Houston intent without spam.
On site updates
- Expanded priority service pages with clear intent sections and FAQs
- Added location signals naturally (service area references, directions, contact consistency)
- Improved internal linking from supporting content to the service pages
- Updated titles and meta descriptions for better CTR
- Added LocalBusiness and FAQ schema where eligible
- Improved speed on mobile templates to reduce drop off
Reviews and Engagement System
We improved review velocity and response consistency using a compliant workflow. Reviews supported trust and conversions, and a steady cadence helped maintain map rankings.
What we implemented
- Compliant review request workflow tied to patient follow ups
- Response templates with consistent tone and timing
- Weekly post schedule and photo refresh routine
- Monitoring of GBP Q and A and prompt replies
Tools Used
Google Business Profile insights, GA4, Google Search Console, call tracking, Looker Studio, BrightLocal or Whitespark, local grid tracking tools, Screaming Frog, PageSpeed Insights and Lighthouse.
Timeline With Dates, Monthly Numbers, and Natural Notes
May 2 to May 31, 2025
We completed the audit, cleaned tracking, fixed quick GBP gaps, and started citation cleanup. Category and service expansion was planned based on competitor benchmarking.
Month end metrics:
- GBP impressions: ~21,400
- Discovery searches: ~1,900
- GBP actions: ~360
- Top 3 map pack keywords: ~0
June 2025
We rebuilt GBP services and categories, started weekly posts and new photos, and continued citation cleanup to remove inconsistencies. Early map movement began as query coverage improved.
Month end metrics:
- GBP impressions: ~38,700
- Discovery searches: ~3,100
- GBP actions: ~620
- Top 3 map pack keywords: ~3
July 2025
We strengthened website service pages and internal linking so the site supported the same Houston intent as GBP. We also launched a steady review workflow to improve trust and engagement.
Month end metrics:
- GBP impressions: ~55,200
- Discovery searches: ~4,700
- GBP actions: ~980
- Top 3 map pack keywords: ~6
August 2025
We refined services and content based on query movement, improved conversions on top pages, and maintained consistent posts, photos, and review responses to stabilize rankings.
Month end metrics
- GBP impressions: ~69,800
- Discovery searches: ~5,900
- GBP actions: ~1,220
- Top 3 map pack keywords: ~8
September 1 to September 2, 2025
We doubled down on what was already ranking, kept engagement consistent, and monitored grid rankings for volatility. This final stretch pushed priority terms into stable top 3 positions.
Month end metrics:
- GBP impressions: ~78,900
- Discovery searches: ~6,800
- GBP actions: ~1,420
- Top 3 map pack keywords: ~9
Before and After Proof Summary
The clinic reached the local 3 pack because GBP service coverage improved, citations became consistent, and the website reinforced the same Houston intent. Consistent posts, photos, and reviews improved engagement signals, helping rankings stabilize.
- GBP impressions: 21,400 to 78,900 per month
- Discovery searches: 1,900 to 6,800 per month
- GBP actions: 360 to 1,420 per month
- Top 3 map pack placements: 0 to 9 tracked keywords
- Calls from Maps + organic: 52 to 176 per month
What Made It Work
The fastest mover was relevance and completeness inside GBP, followed by trust cleanup through citations. Once Google had clear service signals and consistent business data, engagement cadence helped the clinic hold top positions instead of fluctuating.