Provider Demographics
NPI:1467827873
Name:GENESIS: YOUR FIRST STEP, PLLC
Entity Type:Organization
Organization Name:GENESIS: YOUR FIRST STEP, PLLC
Other - Org Name:IRENE L DUNN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:LOUISA
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-757-7999
Mailing Address - Street 1:7760 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-3136
Mailing Address - Country:US
Mailing Address - Phone:915-757-7999
Mailing Address - Fax:915-757-8004
Practice Address - Street 1:7760 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-3136
Practice Address - Country:US
Practice Address - Phone:915-757-7999
Practice Address - Fax:915-757-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128692363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty