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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 Specialty Code Provider Type

Plastic Surgery Within the Head and Neck

2082S0099X 02 Physician/General Surgery
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for GENECOV PLASTIC SURGERY GROUP, PA

NPI # 1164549887
LBN Legal business name GENECOV PLASTIC SURGERY GROUP, PA
Authorized official JULI SMIDDY - (PRACTICE ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 03/26/2007
Last updated 04/16/2021 - About 5 years ago
Identifiers
TX License # 19138
TX License # NA
TX Medicaid 112848004
Other TXB102342 MEDICARE PTAN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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