Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Gena Marie Ettinger, PA-C

Individual provider Physician Assistant · NPI 1578815304

Mrs. Gena Marie Ettinger, PA-C is a Physician Assistant in Southlake, Texas. Licensed in Texas. Registered with an NPI since 2012.

Licensed in
TX
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

505 S Nolen Dr Ste B
Southlake, TX 76092-9167
Phone: (817) 410-7777
Fax: (817) 410-9906
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA08076 (TX)

Record details

NPI number1578815304
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 3, 2012
Last updated in NPPESJuly 9, 2021
Certification dateJuly 9, 2021

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