Provider Demographics
NPI:1083261622
Name:GENEUS HEALTH
Entity Type:Organization
Organization Name:GENEUS HEALTH
Other - Org Name:GENEUS DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-328-0129
Mailing Address - Street 1:16120 COLLEGE OAK STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4044
Mailing Address - Country:US
Mailing Address - Phone:210-694-1323
Mailing Address - Fax:866-200-2799
Practice Address - Street 1:16120 COLLEGE OAK STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4044
Practice Address - Country:US
Practice Address - Phone:210-287-3558
Practice Address - Fax:866-200-2799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-19
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D2170534OtherCLIA