Healthcare Provider Details

I. General information

NPI: 1386034866
Provider Name (Legal Business Name): HOBEN MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2261 NORTHPARK DR BOX 518
KINGWOOD TX
77339-1744
US

IV. Provider business mailing address

2261 NORTHPARK DR BOX 518
KINGWOOD TX
77339-1744
US

V. Phone/Fax

Practice location:
  • Phone: 832-647-1910
  • Fax:
Mailing address:
  • Phone: 832-647-1910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA06898
License Number StateTX

VIII. Authorized Official

Name: JONAS KONAN
Title or Position: ADMINISTRATOR
Credential: PA-C
Phone: 832-647-1910