Active NPI
Genesis Medical Diagnostics
- Clinical Medical Laboratory
- Tomball, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- GENESIS MEDICAL DIAGNOSTICS
- Practice address
- 455 School St Ste 30
Tomball, TX 77375-4595 - Phone
- (800) 951-0182
- Fax
- (832) 565-1921
- NPI assigned
- Jan 26, 2022
- 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
- Ewan Douglas Johnson, MD,PHD
- Title
- Ceo
- Phone
- (281) 516-0212
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
455 School St Ste 30
Tomball, TX 77375-4595
Mailing address
14090 FM 2920 Rd Ste 345G
Tomball, TX 77377-5549
Phone (281) 415-6687
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 45D2245371 | Other | TX | HHS |
National Provider Directory
National Provider Directory- Tax ID family
- Genesis Medical Diagnostics PLLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Houston, TX
- NPI 1386396810
-
- Clinical Medical Laboratory
- Corpus Christi, TX
- NPI 1538835939
Practitioners & affiliated clinicians
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.
-
- Internal Medicine Physician
- Tomball, TX
- NPI 1043521313
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643155200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1643155200000",
"number": "1912659459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14090 FM 2920 RD STE 345G",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773775549",
"telephone_number": "281-415-6687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 SCHOOL ST STE 30",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773754595",
"telephone_number": "800-951-0182",
"fax_number": "832-565-1921"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENESIS MEDICAL DIAGNOSTICS",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-26",
"last_updated": "2022-01-26",
"certification_date": "2022-01-26",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "EWAN",
"authorized_official_middle_name": "DOUGLAS",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "281-516-0212",
"authorized_official_credential": "MD,PHD"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HHS",
"identifier": "45D2245371",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tomball, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.