Provider Demographics
NPI:1760498315
Name:GENSON HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:GENSON HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOSUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-600-1007
Mailing Address - Street 1:6250 WESTPARK DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7322
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6250 WESTPARK DR
Practice Address - Street 2:SUITE 202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7322
Practice Address - Country:US
Practice Address - Phone:713-600-1007
Practice Address - Fax:713-600-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4520010001Medicare ID - Type Unspecified