MEDICARE: HENRY JACOB CONTER MD

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	207RX0202X	Medical Oncology Physician	BP10039584	TX

General Provider Information

NPI Number	:	1821341108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY JACOB CONTER MD

Provider Business Mailing Address
First Line	:	1400 HOLCOMBE BLVD
Second Line	:	UNIT 263
City	:	HOUSTON
State	:	TX
Zip	:	77030-4008
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 HOLCOMBE BLVD
Second Line	:	UNIT 263
City	:	HOUSTON
State	:	TX
Zip	:	77030-4008
Country	:	US
Telephone Number	:	832-516-7374
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2012
Last Update Date	:	10/24/2012

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