Healthcare Provider Details

I. General information

NPI: 1174893929
Provider Name (Legal Business Name): GEORGE DANIEL POPE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11815 WHITE OAK TRL
CONROE TX
77385-2735
US

IV. Provider business mailing address

11815 WHITE OAK TRL
CONROE TX
77385-2735
US

V. Phone/Fax

Practice location:
  • Phone: 281-465-9019
  • Fax:
Mailing address:
  • Phone: 281-465-9019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD7255
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: