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General NPI Number Information
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NPI Number | 1972480945
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Entity Type | Organization
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Legal Business Name | GENERATIONAL HEALTH OF ARKANSAS
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 1100 OAK ST STE V27
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City | CONWAY
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State | AR
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Zip | 72032-4318
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Country | US
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Telephone | 713-338-9901
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Fax | 713-338-9902
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Provider Business Mailing Address
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Address Line | 1100 OAK ST STE V27
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City | CONWAY
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State | AR
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Zip | 72032-4318
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Country | US
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Telephone | 713-338-9901
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Fax | 713-338-9902
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Authorized Official
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Title or Position | OWNER
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Name | EEMAN TARIQ
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Credential | MD
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Telephone | 713-338-9901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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