Healthcare Provider Details

I. General information

NPI: 1003324310
Provider Name (Legal Business Name): HOBEN NEURO GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2018
Last Update Date: 01/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MEDICAL PLAZA DR
SHENANDOAH TX
77380-3476
US

IV. Provider business mailing address

PO BOX 3535
CONROE TX
77305-3535
US

V. Phone/Fax

Practice location:
  • Phone: 936-499-1569
  • Fax: 832-442-4554
Mailing address:
  • Phone: 936-499-1569
  • Fax: 832-442-4554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. JONAS KONAN
Title or Position: OWNER
Credential: PA-C
Phone: 832-647-1910