Healthcare Provider Details

I. General information

NPI: 1538965348
Provider Name (Legal Business Name): GENERATIONAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 NEW ORLEANS AVE
NEW ORLEANS LA
70119
US

IV. Provider business mailing address

3209 NEW ORLEANS AVE
NEW ORLEANS LA
70119
US

V. Phone/Fax

Practice location:
  • Phone: 281-214-9823
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHN DIXON III
Title or Position: MANAGER
Credential:
Phone: 214-985-2624