Genesis Medical Diagnostics PLLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

GENESIS MEDICAL DIAGNOSTICS PLLC

Practice address

9359 Interstate 37 Ste D
Corpus Christi, TX 78409-3200

Phone

(361) 248-4062

Fax

(832) 565-1921

NPI assigned

Jul 23, 2021

Last updated

Sep 16, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ewan Johnson, MD, PHDNPI 1043521313

Title

Ceo/Founder

Phone

(281) 415-6687

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ewan Douglas Johnson, MD, PHD

  • Internal Medicine Physician
  • Tomball, TX
  • NPI 1043521313
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1063085231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14090 FM 2920 RD STE 345G",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773775549",
            "telephone_number": "281-415-6687",
            "fax_number": "832-565-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9359 INTERSTATE 37 STE D",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784093200",
            "telephone_number": "361-248-4062",
            "fax_number": "832-565-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDICAL DIAGNOSTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "EWAN",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "281-415-6687",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "45D2199395",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tim Alan Geffert, DDS
• Griffin Geick, DO
• Andrea Elaine Geldmeier, DPT
• Garrett Christopher Gellerman, DPT
• Mark Wilson Geneser, MD
• Genesis Medical Diagnostics PLLC
• Genoa Healthcare LLC
• Herve F Gentile, MD
• Patrizia E Gentile
• Gentle Dental Spa PLLC

• Clinical Medical Laboratory in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.