GENESIS GYNECOLOGY PA NPI 1174792733

NPI Information

  • NPI: 1174792733
  • Provider Name: GENESIS GYNECOLOGY PA
  • Classification: Obstetrics & Gynecology - 207VG0400X
  • Specialization: Gynecology
  • Entity Type: Organization
  • CLIA Number: 45D1081385
  • Address: 176 FAIRWAY DR
    KERRVILLE, TX
    ZIP 78028
  • Phone: (830) 792-0805

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NPI Details

GENESIS GYNECOLOGY PA is a gynecology obstetrics gynecology in Kerrville, TX. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee GENESIS GYNECOLOGY PA NPI is 1174792733. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

176 FAIRWAY DR
KERRVILLE, TX
ZIP 78028-437
Phone: (830) 792-0805
Fax: (830) 792-0833

The provider's authorized official is Kerri Lee Truelock .
The authorized official title is President and has the following contact phone number (830) 792-0805.

The CLIA number assigned to this NPI record is 45D1081385 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/27/2008 and was last updated on 3/13/2013.

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
1207R00000XInternal MedicineTEXASNo
2207V00000XObstetrics & GynecologyNo
3207VG0400XObstetrics & GynecologyGynecologyYes

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
1193308701MEDICAIDTEXAS
26157650001MEDICARE NSCTEXAS
30083RBOTHERTEXASBCBS OF TEXAS GROUP #
400Z105MEDICARE PINTEXAS

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: 11/21/2025

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