MEDICARE: GLENN GENOVESE MD 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
1	207RP1001X	Pulmonary Disease Physician	H7302	TX
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	H7302	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144228636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLENN GENOVESE MD PA

Provider Business Mailing Address
First Line	:	PO BOX 50268
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76206-0268
Country	:	US
Telephone Number	:	940-484-1500
Fax Number	:	940-484-1700

Provider Business Practice Location Address
First Line	:	3120 MEDPARK DR
Second Line	:	SUITE 150
City	:	CORINTH
State	:	TX
Zip	:	76208-6981
Country	:	US
Telephone Number	:	940-484-1500
Fax Number	:	940-484-1700

Authorized Official
Title or Position	:	MD/OWNER
Name	:	DR. GLENN GENOVESE
Credential	:	MD
Telephone Number	:	940-484-1500

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	02/07/2012

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Directions to “GLENN GENOVESE MD PA ” Practice Location

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