Provider Demographics
NPI:1003629080
Name:GENDI MULTI SPECIALTY GROUP
Entity type:Organization
Organization Name:GENDI MULTI SPECIALTY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WAGIH
Authorized Official - Middle Name:
Authorized Official - Last Name:GENDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-202-5091
Mailing Address - Street 1:1430 PASADENA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-2414
Mailing Address - Country:US
Mailing Address - Phone:713-477-0400
Mailing Address - Fax:713-477-2711
Practice Address - Street 1:1430 PASADENA BLVD STE A
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-2414
Practice Address - Country:US
Practice Address - Phone:713-477-0400
Practice Address - Fax:713-477-2711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)