Provider Demographics
NPI:1912180068
Name:MARRIOTT- EMFINGER, GENEE' (LSA, CSA, RTR)
Entity type:Individual
Prefix:
First Name:GENEE'
Middle Name:
Last Name:MARRIOTT- EMFINGER
Suffix:
Gender:F
Credentials:LSA, CSA, RTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8556
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77387-8556
Mailing Address - Country:US
Mailing Address - Phone:936-494-8266
Mailing Address - Fax:936-582-4445
Practice Address - Street 1:9200 PINECROFT DR.
Practice Address - Street 2:SUITE 400
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:936-494-8266
Practice Address - Fax:936-582-4445
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00358246ZC0007X, 174400000X
363AS0400X, 246ZX2200X
487388246ZS0410X
06-325246Z00000X
128772471C3402X, 247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00358OtherLSA LICENSE - TEXAS MEDICAL BOARD
487388OtherNCCT CETIFICATION - TECH IN SURGERY
06-325OtherCERTFICATION - AMERICAN BOARD OF SURGICAL ASSISTANTS
TX12877OtherTEXAS MEDICAL BOARD - RADIOLOGIC TECHNOLOGIST