Organization
GENCARE SPINE AND PAIN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAN KELLY NGUYEN MD (PRESIDENT)
(281) 636-6101
Entity
Organization
Contact information
Practice address
1101 ALMA ST STE 106, TOMBALL, TX 77375-4559
(281) 636-6101
(281) 667-0910
Mailing address
4830 WILSON RD STE 300, PMB 205, HUMBLE, TX 77396-1972
(281) 636-6101
(281) 667-0910
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
740207
MEDICARE
TX
Enumeration date
06/04/2018
Last updated
04/10/2020
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