GENESIS HEALTH AND WELLNESS PA NPI 1790974541

NPI Information

NPI: 1790974541
Provider Name: GENESIS HEALTH AND WELLNESS, PA
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

CLIA Number: 45D1051637

Address:
4855 RIVERSTONE BLVD
STE. 103
MISSOURI CITY, TX
ZIP 77459
Phone: (281) 313-6348
Get Directions

GENESIS HEALTH AND WELLNESS, PA is an adult medicine family medicine in Missouri City, TX. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. GENESIS HEALTH AND WELLNESS, PA NPI is 1790974541. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4855 RIVERSTONE BLVD
STE. 103
MISSOURI CITY, TX
ZIP 77459-377
Phone: (281) 313-6348
Fax: (281) 313-6349

The provider's authorized official is Frederick Brown .
The authorized official title is Owner and has the following contact phone number (281) 313-6348.

The CLIA number assigned to this NPI record is 45D1051637 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/17/2007 and was last updated on 2/7/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	160693101	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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