Provider Demographics
NPI:1134200595
Name:GENESIS NURSING SERVICES, PLLC
Entity type:Organization
Organization Name:GENESIS NURSING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PIETRZAK
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:956-648-0705
Mailing Address - Street 1:924 W NOLANA RD STE D
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-7934
Mailing Address - Country:US
Mailing Address - Phone:956-702-3500
Mailing Address - Fax:
Practice Address - Street 1:924 W NOLANA RD STE D
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-7934
Practice Address - Country:US
Practice Address - Phone:956-702-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX695750251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health