Healthcare Provider Details

I. General information

NPI: 1073710828
Provider Name (Legal Business Name): CONDE NEVIN ANDERSON JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CONDE NEVIN ANDERSON MD

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 FORMOSA DR.
POINT COMFORT TX
77978
US

IV. Provider business mailing address

201 FORMOSA DR.
POINT COMFORT TX
77978
US

V. Phone/Fax

Practice location:
  • Phone: 361-987-7445
  • Fax: 361-284-1234
Mailing address:
  • Phone: 361-987-7441
  • Fax: 361-987-7492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE0785
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: