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NPI Code Detail

MEDICARE: CONRAD LO INC

MEDICARE: CONRAD LO INC
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
1363AS0400XSurgical Physician AssistantPA04350TX

General Provider Information

NPI Number : 1922351865
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONRAD LO INC
Provider Business Mailing Address
First Line : 7001 CORPORATE DR
Second Line : SUITE 100
City : HOUSTON
State : TX
Zip : 77036-5192
Country : US
Telephone Number : 713-777-1886
Fax Number :
Provider Business Practice Location Address
First Line : 7001 CORPORATE DR
Second Line : SUITE 100
City : HOUSTON
State : TX
Zip : 77036-5192
Country : US
Telephone Number : 713-777-1886
Fax Number :
Authorized Official
Title or Position : PHYSICIAN ASSISTANT SURGICAL
Name : MR. CONRAD CALVIN LO
Credential : PA-C
Telephone Number : 713-777-1886
Provider Enumeration Date : 10/16/2012
Last Update Date : 10/16/2012

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Directions to “CONRAD LO INC ” Practice Location

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