Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 31528 | TX |
NPI | 1114143054 |
---|---|
Provider Name | Dr. David Steven Genac |
First Address | Houston, TX 77006-1711 |
Second Address | Houston, TX 77006-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |