Provider Demographics
NPI:1538531769
Name:NEW GEN OF HEALTHCARE PLLC
Entity type:Organization
Organization Name:NEW GEN OF HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWGENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-655-3328
Mailing Address - Street 1:8609 SOUTHWESTERN BLVD
Mailing Address - Street 2:623
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-2675
Mailing Address - Country:US
Mailing Address - Phone:318-655-3328
Mailing Address - Fax:
Practice Address - Street 1:8609 SOUTHWESTERN BLVD
Practice Address - Street 2:623
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-2675
Practice Address - Country:US
Practice Address - Phone:318-655-3328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2690282N00000X, 283Q00000X, 283X00000X, 282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
No282N00000XHospitalsGeneral Acute Care Hospital
No283Q00000XHospitalsPsychiatric Hospital
No283X00000XHospitalsRehabilitation Hospital