NPIMap

Organization Active NPI

Genetic Diagnostic Group

  • Clinical Biochemical Genetics Physician
  • Dallas, TX
National Provider Identifier
1063665941
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Biochemical Genetics PhysicianTaxonomy code 207SG0202X
Legal business name
GENETIC DIAGNOSTIC GROUP
Practice address
6000 Harry Hines Blvd
Hamon BLDG, Room Na2 508a
Dallas, TX 75390-0001
Phone
(214) 645-0624
NPI assigned
Oct 23, 2008
Last updated
Feb 24, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLASAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Authorized official

Name
Bruce Fairbanks
Title
Vice President
Phone
(214) 648-0309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Biochemical Genetics Physician 207SG0202X Primary

Addresses

Primary practice location

6000 Harry Hines Blvd
Hamon BLDG, Room Na2 508a
Dallas, TX 75390-0001

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

National Provider Directory

National Provider Directory
Tax ID family
Utsouthwestern Medical Center79 organizations share this tax ID, including this one
Part of
Utsouthwestern Medical Center

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298505600000",
    "number": "1063665941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 HARRY HINES BLVD",
            "address_2": "HAMON BLDG, ROOM NA2 508A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753900001",
            "telephone_number": "214-645-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENETIC DIAGNOSTIC GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "enumeration_date": "2008-10-23",
        "last_updated": "2011-02-24",
        "status": "A",
        "authorized_official_last_name": "FAIRBANKS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "214-648-0309"
    },
    "taxonomies": [
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.