Individual
DR. MICHAEL JAMES GENNRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4515 SETON CENTER PKWY, #220, AUSTIN, TX 78759
(512) 338-8388
(512) 338-8430
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N1325
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197715908
—
TX
05
—
197715909
—
TX
05
—
197715910
—
TX
Enumeration date
05/27/2007
Last updated
06/27/2018
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