National Provider Identifier Database

GENECOV PLASTIC SURGERY GROUP PA
Plastic Surgery Within the Head and Neck

A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them.


Contact Information

GENECOV PLASTIC SURGERY GROUP, PA
7777 FOREST LN STE C528
DALLAS, TX75230-6848
Phone: 972-331-1900
Fax: 972-331-1909
Website:
Specialty Taxonomy Code
* Plastic Surgery Within the Head and Neck 2082S0099X
Speech-Language Pathologist 235Z00000X

* Indicates primary specialty

NPI Profile & details for GENECOV PLASTIC SURGERY GROUP, PA

NPI Number 1164549887
Legal business name
LBN
GENECOV PLASTIC SURGERY GROUP, PA
Authorized official JULI SMIDDY - (PRACTICE ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 03/26/2007
Last updated 04/16/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • TX License #: 19138
  • TX License #: NA
  • TX Medicaid: 112848004
  • Other: TXB102342 MEDICARE PTAN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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