Provider Demographics
NPI:1760485262
Name:GENUNG, JOHN ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALLEN
Last Name:GENUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4700 SETON CENTER PKWY
Mailing Address - Street 2:STE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5295
Mailing Address - Country:US
Mailing Address - Phone:512-439-1000
Mailing Address - Fax:412-439-1081
Practice Address - Street 1:4700 SETON CENTER PKWY
Practice Address - Street 2:STE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5295
Practice Address - Country:US
Practice Address - Phone:512-439-1000
Practice Address - Fax:412-439-1081
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD4126207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115986504Medicaid
TX115986502Medicaid
TXP00690920OtherMEDICARE RAILROAD
TXB22935Medicare UPIN
TX0366280007Medicare NSC
TX8L5892Medicare PIN
TX115986504Medicaid
TX8L5891Medicare PIN
TX115986502Medicaid