Genesis II Age Management, P.a.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

E1000 Issued in TX

Legal business name

GENESIS II AGE MANAGEMENT, P.A.

Practice address

515 W. Mayfield Road
Suite 416
Arlington, TX 76014-2085

Phone

(817) 419-8748

Fax

(817) 419-8788

NPI assigned

Oct 15, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Ronald Steven Kline, M.D.

Title

President

Phone

(817) 419-8748

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1318636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318636800000",
    "number": "1114202611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W. MAYFIELD ROAD",
            "address_2": "SUITE 416",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142085",
            "telephone_number": "817-419-8748",
            "fax_number": "817-419-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W. MAYFIELD ROAD",
            "address_2": "SUITE 416",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142085",
            "telephone_number": "817-419-8748",
            "fax_number": "817-419-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS II AGE MANAGEMENT, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-15",
        "last_updated": "2011-10-15",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-419-8748",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "TX",
            "license": "E1000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Arlington, TX
• Providers in Arlington, TX by specialty
• Health Service Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.