Provider Demographics
NPI:1023546603
Name:GEORGE NWOSUH
Entity Type:Organization
Organization Name:GEORGE NWOSUH
Other - Org Name:GENSON & ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CRENDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-666-4685
Mailing Address - Street 1:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:ALIEF
Mailing Address - State:TX
Mailing Address - Zip Code:77411-0201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2107 BRUSHMEADE LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-8822
Practice Address - Country:US
Practice Address - Phone:832-232-4814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016471041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty