| Conroe-woodlands Gastroenterology, P.a. | |
|
1020 Riverwood Ct Ste 300 Conroe TX 77304-2974 | |
| (936) 760-1900 | |
| (936) 441-1907 |
| Full Name | Conroe-woodlands Gastroenterology, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1020 Riverwood Ct Ste 300, Conroe, Texas |
| Authorized Official Name and Position | Stephen Michael Kelly (PRESIDENT) |
| Authorized Official Contact | 9367601900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conroe-woodlands Gastroenterology, P.a. 1020 Riverwood Ct Ste 300 Conroe TX 77304-2974 Ph: (936) 760-1900 | Conroe-woodlands Gastroenterology, P.a. 1020 Riverwood Ct Ste 300 Conroe TX 77304-2974 Ph: (936) 760-1900 |
| NPI Number | 1962539155 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 08/29/2023 |
| Medicare PECOS PAC ID | 7618957028 |
|---|---|
| Medicare Enrollment ID | O20040724000123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962539155 | NPI | - | NPPES |
| 1729485 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Stephen Michael Kelly |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245367663 PECOS PAC ID: 1355253071 Enrollment ID: I20040727000911 |
| Provider Name | Michael Warren Robles |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1427034495 PECOS PAC ID: 7618947334 Enrollment ID: I20040729001021 |
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