Provider Demographics
NPI:1457906851
Name:DUFFEY, GENETIA SEANTEA
Entity Type:Individual
Prefix:
First Name:GENETIA
Middle Name:SEANTEA
Last Name:DUFFEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 COLLINS CIR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:75686-9542
Mailing Address - Country:US
Mailing Address - Phone:469-243-7994
Mailing Address - Fax:
Practice Address - Street 1:109 COLLINS CIR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:TX
Practice Address - Zip Code:75686-9542
Practice Address - Country:US
Practice Address - Phone:469-243-7994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-03
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty