Organization Active NPI

Genecov Plastic Surgery Group

  • Ambulatory Surgical Clinic/Center
  • Dallas, TX
National Provider Identifier
1306934724
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
1833 Issued in TX
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
HH1564OtherTXBCBS OF TEXAS

Other names 1

  • Genecov Plastic Surgery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Craniofacial Imaging3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

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.

Verify at the official NPI Registry.