| Genesis Primecare | |
|
1900 E End Blvd N Marshall TX 75670 | |
| (903) 927-6620 | |
| (903) 927-6625 |
| Full Name | Genesis Primecare |
|---|---|
| Speciality | Clinic/Center |
| Location | 1900 E End Blvd N, Marshall, Texas |
| Authorized Official Name and Position | Carla Roadcap (CEO) |
| Authorized Official Contact | 9039273782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Primecare Po Box 1326 Marshall TX 75671-1326 Ph: (903) 927-3782 | Genesis Primecare 1900 E End Blvd N Marshall TX 75670 Ph: (903) 927-6620 |
| NPI Number | 1053845636 |
|---|---|
| Provider Enumeration Date | 04/20/2017 |
| Last Update Date | 11/13/2025 |
| Certification Date | 11/13/2025 |
| Medicare PECOS PAC ID | 8820038565 |
|---|---|
| Medicare Enrollment ID | O20170613002665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053845636 | NPI | - | NPPES |
| 372586301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
| 174400000X | Specialist | (NU) | Secondary |
| 208000000X | Pediatrics | (NU) | Secondary |
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