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General NPI Number Information
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NPI Number | 1386870673
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Entity Type | Individual
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Provider Name | MARLYN GENERILLO M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 3129 KINGSLEY DR STE 1940
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City | PEARLAND
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State | TX
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Zip | 77584-8511
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Country | US
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Telephone | 281-971-0809
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Fax | 949-864-3114
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Provider Business Mailing Address
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Address Line | 3129 KINGSLEY DR STE 1940
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City | PEARLAND
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State | TX
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Zip | 77584-8511
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Country | US
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Telephone | 281-971-0809
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Fax | 949-864-3114
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 45673
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301093903
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | Q1151
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License Number State | TX
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