Healthcare Provider Details

I. General information

NPI: 1588859821
Provider Name (Legal Business Name): ROBERT J. GENOVESE, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 03/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 S MCCOLL RD
EDINBURG TX
78539-7861
US

IV. Provider business mailing address

5215 S MCCOLL RD
EDINBURG TX
78539-7861
US

V. Phone/Fax

Practice location:
  • Phone: 956-631-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE5522
License Number StateTX

VIII. Authorized Official

Name: MRS. CARMEN MARIE URBINA
Title or Position: OFFICE MGR.
Credential:
Phone: 956-631-7100