| Conroe Endocrinology Center | |
|
150 Pine Forest Dr # 103 Shenandoah TX 77384-5302 | |
| (936) 755-4238 | |
| (936) 755-5979 |
| Full Name | Conroe Endocrinology Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 150 Pine Forest Dr # 103, Shenandoah, Texas |
| Authorized Official Name and Position | Kateryna Komarovskiy (OWNER) |
| Authorized Official Contact | 9367554238 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conroe Endocrinology Center 150 Pine Forest Dr #103 Shenandoah TX 77384 Ph: (936) 755-4238 | Conroe Endocrinology Center 150 Pine Forest Dr # 103 Shenandoah TX 77384-5302 Ph: (936) 755-4238 |
| NPI Number | 1366984288 |
|---|---|
| Provider Enumeration Date | 11/09/2016 |
| Last Update Date | 02/01/2023 |
| Medicare PECOS PAC ID | 6507140936 |
|---|---|
| Medicare Enrollment ID | O20170303000900 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366984288 | NPI | - | NPPES |
| 350299901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | N8941 (Texas) | Primary |
| Provider Name | Kateryna Komarovskiy |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1265694285 PECOS PAC ID: 3577622752 Enrollment ID: I20111117000498 |
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