Active NPI
Genecov Plastic Surgery Group
- Ambulatory Surgical Clinic/Center
- Dallas, TX
National Provider Identifier
1306934724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- 1833
- Legal business name
- GENECOV PLASTIC SURGERY GROUP
- Practice address
- 7777 Forest LN
Suite C720
Dallas, TX 75230-2505 - Phone
- (972) 566-6555
- Fax
- (972) 566-6017
- NPI assigned
- Oct 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David G Genecov, M.D.
- Title
- Medical Director
- Phone
- (972) 566-6555
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 1833 | TX | Primary |
Addresses
Primary practice location
7777 Forest LN
Suite C720
Dallas, TX 75230-2505
Mailing address
7777 Forest LN
Suite C717
Dallas, TX 75230-2505
Phone (972) 566-6555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HH1564 | Other | TX | BCBS OF TEXAS |
Other names 1
- Genecov Plastic Surgery Center
National Provider Directory
National Provider Directory- Tax ID family
- Craniofacial Imaging
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Radiology Clinic/Center
- Dallas, TX
- NPI 1417021247
-
- Plastic Surgery Physician
- Dallas, TX
- NPI 1639296353
Locations
7777 Forest Ln
Ste C717
Dallas, TX 75230
Phone (972) 566-6555
7777 Forest Ln
Ste C720
Dallas, TX 75230
Phone (972) 566-6555
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1306934724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7777 FOREST LN",
"address_2": "SUITE C717",
"city": "DALLAS",
"state": "TX",
"postal_code": "752302505",
"telephone_number": "972-566-6555",
"fax_number": "972-566-6017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7777 FOREST LN",
"address_2": "SUITE C720",
"city": "DALLAS",
"state": "TX",
"postal_code": "752302505",
"telephone_number": "972-566-6555",
"fax_number": "972-566-6017"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENECOV PLASTIC SURGERY GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-11",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "GENECOV",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "972-566-6555",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "TX",
"license": "1833",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "HH1564",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Genecov Plastic Surgery Center",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.