| Organization Name: | GENECOV PLASTIC SURGERY GROUP, PA |
| NPI Number: | 1164549887 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULI SMIDDY (PRACTICE ADMINISTRATOR) |
| Mailing Address: | 11970 N Central Expy Ste 270 Dallas |
| State: | TX US |
| Postal Code: | 752433770 |
| Phone Number: | 9723311900 |
| Fax Number: | 9723311909 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 05/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 19138 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |