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NPI Code Detail

MEDICARE: HLTX2 PA

MEDICARE: HLTX2 PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1134937980
Entity Type Code : Organization
Provider Name (Legal Business Name) : HLTX2 PA
Provider Business Mailing Address
First Line : 100 CRESCENT CT STE 700
Second Line :
City : DALLAS
State : TX
Zip : 75201-2112
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 CRESCENT CT STE 700
Second Line :
City : DALLAS
State : TX
Zip : 75201-2112
Country : US
Telephone Number : 310-892-4284
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. LAWRENCE GENEN
Credential : MD
Telephone Number : 310-892-4284
Provider Enumeration Date : 12/26/2024
Last Update Date : 12/26/2024

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Directions to “HLTX2 PA ” Practice Location

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