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NPI Code Detail

MEDICARE: SOUTHEAST TEXAS HYPERBARIC MEDICINE

MEDICARE: SOUTHEAST TEXAS HYPERBARIC MEDICINE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistG5492TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11306800412OTHERTXNPI BAPONTANI
21760446561OTHERTXNPI RLWILLIAMS

General Provider Information

NPI Number : 1992802425
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHEAST TEXAS HYPERBARIC MEDICINE
Provider Business Mailing Address
First Line : PO BOX 988
Second Line :
City : CONROE
State : TX
Zip : 77305-0988
Country : US
Telephone Number : 936-539-7034
Fax Number :
Provider Business Practice Location Address
First Line : 500 MEDICAL CENTER BLVD STE 110
Second Line :
City : CONROE
State : TX
Zip : 77304-2800
Country : US
Telephone Number : 936-539-7034
Fax Number :
Authorized Official
Title or Position : PHYSICIAN/OWNER
Name : DR. BRADLEY A PONTANI
Credential : M.D.
Telephone Number : 936-539-7034
Provider Enumeration Date : 09/19/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

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1871572123 — DR. JAMES PETER BONAR M.D.
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1780634394 — DR. CO H NGUYEN M.D
Practice Location Address:
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1831131374 — DR. MOTAHAR QAADRI D.C.
Practice Location Address:
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1043232481 — DR. MARK STEPHENSON D.D.S.
Practice Location Address:
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Practice Fax: 936-760-2226

Directions to “SOUTHEAST TEXAS HYPERBARIC MEDICINE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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