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General NPI Number Information
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NPI Number | 1609484567
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Entity Type | Organization
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Legal Business Name | GEN MED INC
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Dates
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Enumeration Date | 07/16/2020
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Last Update Date | 07/16/2020
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Provider Practice Location Address
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Address Line | 253 ROUTE 211 EAST 2ND FLOOR
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City | MIDDLETOWN
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State | NY
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Zip | 10940
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Country | US
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Telephone | 713-201-3607
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 WAUGH DR # 909
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City | HOUSTON
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State | TX
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Zip | 77019-3908
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Country | US
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Telephone | 713-201-3607
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLENN D BABUS
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Credential | DO
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Telephone | 713-201-3607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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