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General NPI Number Information
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NPI Number | 1629157599
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Entity Type | Organization
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Legal Business Name | CONROE EYE CLINIC, LLP
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 333 N. RIVERSHIRE DR. STE. 160
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City | CONROE
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State | TX
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Zip | 77304-2711
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Country | US
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Telephone | 936-441-2020
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Fax | 936-756-0656
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Provider Business Mailing Address
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Address Line | 333 N. RIVERSHIRE DR. STE. 160
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City | CONROE
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State | TX
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Zip | 77304-2711
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Country | US
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Telephone | 936-441-2020
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Fax | 936-756-0656
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | EDNA PRICE
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Credential |
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Telephone | 936-441-1440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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