Genprov LLC

NPI #1487141032 in Pearland, Texas

Provider Information

NPI Number: 1487141032
Entity Type: Organization
Organization Name: Genprov LLC
Primary Specialty: Emergency Medicine
Enumeration Date: Apr 19, 2018
Last Updated: Apr 19, 2018

Practice Location

Address: 2301 HARBOR CHASE DRIVE
City: Pearland
State: Texas
ZIP Code: 77584
Phone: (404) 441-8752

Authorized Official

Name: DR. ROGER OLADE, MD
Title: OWNER
Phone: (404) 441-8752

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Emergency Medicine	207P00000X	Primary

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