Provider Demographics
NPI:1710214119
Name:CENTER FOR MEDICAL GENETICS, PLLC
Entity Type:Organization
Organization Name:CENTER FOR MEDICAL GENETICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:H
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-790-1990
Mailing Address - Street 1:2101 S M ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1591
Mailing Address - Country:US
Mailing Address - Phone:956-682-5777
Mailing Address - Fax:956-630-2240
Practice Address - Street 1:2101 S M ST
Practice Address - Street 2:SUITE B
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1591
Practice Address - Country:US
Practice Address - Phone:956-682-5777
Practice Address - Fax:956-630-2240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1699207SC0300X, 207SG0201X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207SC0300XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical CytogeneticsGroup - Single Specialty
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX020788801Medicaid
TX020788802Medicaid
TX0075ATMedicare PIN
TX020788802Medicaid
TXG37742Medicare UPIN