Provider Demographics
NPI:1538937040
Name:GENESIS HEALTHCARE ASSOCIATES PLLC
Entity type:Organization
Organization Name:GENESIS HEALTHCARE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/EMPLOYEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHUONG
Authorized Official - Middle Name:T
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:409-237-5133
Mailing Address - Street 1:2770 AERO DR STE 3
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-1519
Mailing Address - Country:US
Mailing Address - Phone:409-237-5133
Mailing Address - Fax:409-237-5162
Practice Address - Street 1:2770 AERO DR STE 3
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-1519
Practice Address - Country:US
Practice Address - Phone:409-237-5133
Practice Address - Fax:409-237-5162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty