Organization
GENESIS HEALTH FITNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER OLADE MD (OWNER)
(832) 263-7490
Entity
Organization
Contact information
Practice address
12155 SHADOW CREEK PKWY STE 114, PEARLAND, TX 77584-7289
(832) 263-7490
(888) 977-1299
Mailing address
12155 SHADOW CREEK PKWY STE 114, PEARLAND, TX 77584-7289
(832) 263-7490
(888) 977-1299
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
261QE0002X
Emergency Care Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05853676
ECFMG
—
Enumeration date
12/08/2020
Last updated
09/25/2023
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