Organization · NPI-2

1488 Family Medicine Group, PLLC

Clinic/Center, Primary Care · Conroe, TX

NPI number1023564325
StatusActive
Last updated in NPPESAug 30, 2016

Details

NPI
1023564325
Entity type
Organization (NPI-2)
Legal business name
1488 Family Medicine Group, PLLC
Organization subpart
No
Enumeration date
Aug 28, 2016
Last updated
Aug 30, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QP2300X Clinic/Center, Primary CareN6330TXYes

Practice location

2400 Fm 1488
Suite 400
Conroe, TX 77384

Phone 936-270-8008 · Fax 936-270-8009

Mailing address

3440 Riley Fuzzell Rd
#120 Pmb 29
Spring, TX 77386-4188

Phone 936-270-8008 · Fax 936-270-8009

Authorized official

Gunther Groning
Sole Member - Manager
9362708008

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