Organization Active NPI

Genesis Family Care, P.a.

  • Family Medicine Physician
  • Katy, TX
National Provider Identifier
1336294925
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L7645 Issued in TX
Legal business name
GENESIS FAMILY CARE, P.A.
Practice address
707 S Fry Rd
Ste 455
Katy, TX 77450-2256
Phone
(281) 579-2035
NPI assigned
Jan 24, 2007
Last updated
Aug 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Dr. Elizabeth Alvarez, M.D.NPI 1457358293
Title
President
Phone
(281) 579-2035

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L7645 TX Primary

Addresses

Primary practice location

707 S Fry Rd
Ste 455
Katy, TX 77450-2256

Mailing address

707 S Fry Rd Ste 455
Katy, TX 77450-2248
Phone (281) 579-2035

Other identifiers 2

IdentifierTypeStateIssuer
0027MNOtherBLUE CROSS BLUE SHIELD
761988OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050407000169 TX Part B Supplier - Clinic/Group Practice 1355398793 Receives reassigned benefits from 1 practitioner
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Locations

1623 S Fry Rd
Katy, TX 77450
Phone (281) 579-2035

707 S Fry Rd
Ste 455
Katy, TX 77450
Phone (281) 579-2035

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1336294925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S FRY RD STE 455",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774502248",
            "telephone_number": "281-579-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S FRY RD",
            "address_2": "STE 455",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774502256",
            "telephone_number": "281-579-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS FAMILY CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-579-2035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L7645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0027MN",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "761988",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.