Organization
DAVID P ELLENT PLLC
Active
Other names
Genesis Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN TARASENKO (COO)
(281) 908-0686
Entity
Organization
Contact information
Practice address
22001 NORTHPARK DR STE 220, KINGWOOD, TX 77339-3810
(281) 319-8399
Mailing address
22001 NORTHPARK DR STE 220, KINGWOOD, TX 77339-3811
(281) 908-0686
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
04/26/2023
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