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General NPI Number Information
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NPI Number | 1821894601
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Entity Type | Organization
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Legal Business Name | GENERATIONAL HEALTH OF TEXAS
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 6833 COIT RD STE 104
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City | PLANO
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State | TX
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Zip | 75024-5400
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Country | US
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Telephone | 281-214-9823
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Fax |
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Provider Business Mailing Address
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Address Line | 6833 COIT RD STE 104
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City | PLANO
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State | TX
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Zip | 75024-5400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE SMITH
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Credential | MD
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Telephone | 770-883-3253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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