| Conroe Family Medicine, Pa | |
|
3205 W Davis St Ste B150 Conroe TX 77304-2066 | |
| (936) 756-6661 | |
| (936) 756-6681 |
| Full Name | Conroe Family Medicine, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 3205 W Davis St, Conroe, Texas |
| Authorized Official Name and Position | Jack Pieniazek (PHYSICIAN) |
| Authorized Official Contact | 9367566661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Conroe Family Medicine, Pa 3205 W Davis St Ste B150 Conroe TX 77304-2066 Ph: (936) 756-6661 | Conroe Family Medicine, Pa 3205 W Davis St Ste B150 Conroe TX 77304-2066 Ph: (936) 756-6661 |
| NPI Number | 1811991524 |
|---|---|
| Provider Enumeration Date | 06/09/2005 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811991524 | NPI | - | NPPES |
| 145630301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K0541 (Texas) | Primary |
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