Provider Demographics
NPI:1740325133
Name:PRISACARU, GENOVEVA NICOLETA (MD)
Entity type:Individual
Prefix:DR
First Name:GENOVEVA
Middle Name:NICOLETA
Last Name:PRISACARU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11564 CEDARCLIFFE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-3523
Mailing Address - Country:US
Mailing Address - Phone:512-442-2300
Mailing Address - Fax:512-442-2303
Practice Address - Street 1:11615 ANGUS RD STE 108
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4064
Practice Address - Country:US
Practice Address - Phone:512-574-6041
Practice Address - Fax:512-442-2303
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2020-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM5449207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185720301Medicaid
TX185720302OtherCSHCN
TX8L11276Medicare PIN
TX185720302OtherCSHCN