Genprov LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

Q2173 Issued in TX

Legal business name

GENPROV LLC

Practice address

2301 Harbor Chase Drive
Pearland, TX 77584

Phone

(404) 441-8752

NPI assigned

Apr 19, 2018

Last updated

Apr 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Roger Olade, MDNPI 1063417715

Title

Owner

Phone

(404) 441-8752

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

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.

• Roger B Olade, MD

  • Internal Medicine Physician
  • Pearland, TX
  • NPI 1063417715

  Emergency Medicine

  NPD Authorized official

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1487141032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 HARBOR CHASE DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775843423",
            "telephone_number": "404-441-8752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HARBOR CHASE DRIVE",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77584",
            "telephone_number": "404-441-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENPROV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "OLADE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-441-8752",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q2173",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q2173",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "Q2173",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tisha Marie Baton General, DMD, MSD
• Marlyn Generillo, M.D.
• Generillomd
• Genesis Health Fitness PLLC
• Genoa Healthcare LLC
• Gabrielle Iris Marie George, OTD, OTR/L
• Jeemol George, FNP-C
• Reijo George
• Sheeba George, MS, APRN,ACNPC-AG
• Martha Frances Gerteisen, M.D.

• Emergency Medicine Physician in Pearland, TX
• Providers in Pearland, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.