| Conroe Willis Family Medicine, Pllc | |
|
4015 I 45 N Ste 220 Conroe TX 77304-5076 | |
| (936) 441-1122 | |
| (936) 788-9151 |
| Full Name | Conroe Willis Family Medicine, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4015 I 45 N Ste 220, Conroe, Texas |
| Authorized Official Name and Position | Robert Jeremy Laningham (PHYSICIAN/ CO-OWNER) |
| Authorized Official Contact | 9364411122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conroe Willis Family Medicine, Pllc 4015 I 45 N Ste 220 Conroe TX 77304-5076 Ph: (936) 441-1122 | Conroe Willis Family Medicine, Pllc 4015 I 45 N Ste 220 Conroe TX 77304-5076 Ph: (936) 441-1122 |
| NPI Number | 1508249798 |
|---|---|
| Provider Enumeration Date | 07/07/2015 |
| Last Update Date | 04/04/2023 |
| Medicare PECOS PAC ID | 9931401320 |
|---|---|
| Medicare Enrollment ID | O20151231000117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508249798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rodney J Laningham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821185703 PECOS PAC ID: 5698806834 Enrollment ID: I20100701000490 |
| Provider Name | Robert J Laningham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700973682 PECOS PAC ID: 7416080387 Enrollment ID: I20101116000059 |
| Provider Name | Simi M Koshy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346533841 PECOS PAC ID: 8426274135 Enrollment ID: I20140731002462 |
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