Healthcare Provider Details

I. General information

NPI: 1871406629
Provider Name (Legal Business Name): GENIA VERLENE BEARD-SKILANG CST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GENIA V BEARD CST

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7127 AZURE WATERS
CONVERSE TX
78109-0407
US

IV. Provider business mailing address

7127 AZURE WATERS
CONVERSE TX
78109-0407
US

V. Phone/Fax

Practice location:
  • Phone: 731-298-9372
  • Fax:
Mailing address:
  • Phone: 731-298-9372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number135896
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: