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General NPI Number Information
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NPI Number | 1144765751
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Entity Type | Individual
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Provider Name | MR. GEEN JOHN
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Gender | Male
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Dates
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Enumeration Date | 01/05/2017
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 9522 BROADWAY ST
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City | PEARLAND
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State | TX
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Zip | 77584-7724
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Country | US
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Telephone | 586-764-4079
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Fax |
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Provider Business Mailing Address
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Address Line | 23865 FM 1314 RD
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City | PORTER
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State | TX
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Zip | 77365-3727
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Country | US
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Telephone | 586-764-4079
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP133987
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License Number State | TX
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