MEDICARE: GENERATIONAL HEALTH OF ARKANSAS

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1972480945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERATIONAL HEALTH OF ARKANSAS

Provider Business Mailing Address
First Line	:	1100 OAK ST STE V27
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72032-4318
Country	:	US
Telephone Number	:	713-338-9901
Fax Number	:	713-338-9902

Provider Business Practice Location Address
First Line	:	1100 OAK ST STE V27
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72032-4318
Country	:	US
Telephone Number	:	713-338-9901
Fax Number	:	713-338-9902

Authorized Official
Title or Position	:	OWNER
Name	:	EEMAN TARIQ
Credential	:	MD
Telephone Number	:	713-338-9901

Provider Enumeration Date	:	08/20/2025
Last Update Date	:	08/20/2025

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Directions to “GENERATIONAL HEALTH OF ARKANSAS ” Practice Location

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