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General NPI Number Information
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NPI Number | 1003324310
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Entity Type | Organization
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Legal Business Name | HOBEN NEURO GROUP LLC
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Dates
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Enumeration Date | 01/21/2018
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Last Update Date | 01/21/2018
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Provider Practice Location Address
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Address Line | 1111 MEDICAL PLAZA DR
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City | SHENANDOAH
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State | TX
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Zip | 77380-3476
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Country | US
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Telephone | 936-499-1569
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Fax | 832-442-4554
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Provider Business Mailing Address
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Address Line | PO BOX 3535
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City | CONROE
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State | TX
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Zip | 77305-3535
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Country | US
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Telephone | 936-499-1569
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Fax | 832-442-4554
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Authorized Official
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Title or Position | OWNER
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Name | MR. JONAS KONAN
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Credential | PA-C
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Telephone | 832-647-1910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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