MEDICARE: LEO A. CONGER JR., M.D. PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G8813	TX

General Provider Information

NPI Number	:	1528002250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEO A. CONGER JR., M.D. PA

Provider Business Mailing Address
First Line	:	1300 E 6TH AVE
Second Line	:	SUITE 100
City	:	BELTON
State	:	TX
Zip	:	76513-2810
Country	:	US
Telephone Number	:	254-778-5400
Fax Number	:	254-778-5444

Provider Business Practice Location Address
First Line	:	1300 E 6TH AVE
Second Line	:	SUITE 100
City	:	BELTON
State	:	TX
Zip	:	76513-2810
Country	:	US
Telephone Number	:	254-778-5400
Fax Number	:	254-778-5444

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LEO ARNOLD CONGER JR.
Credential	:	M.D.
Telephone Number	:	254-778-5400

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	09/24/2014

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