Conroe Vascular and Interventional LLP

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

CONROE VASCULAR AND INTERVENTIONAL LLP

Practice address

100 Medical Center Blvd Ste 118
Conroe, TX 77304-2821

Phone

(936) 539-4031

Fax

(936) 539-4537

NPI assigned

Apr 3, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mobolaji Odelowo, MDNPI 1073562419

Title

Managing Partner

Phone

(936) 539-4031

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mobolaji Odelowo, MD

  • Vascular & Interventional Radiology Physician
  • Conroe, TX
  • NPI 1073562419
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1093211591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER BLVD STE 118",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042821",
            "telephone_number": "936-539-4031",
            "fax_number": "936-539-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER BLVD STE 118",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042821",
            "telephone_number": "936-539-4031",
            "fax_number": "936-539-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROE VASCULAR AND INTERVENTIONAL LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "ODELOWO",
        "authorized_official_first_name": "MOBOLAJI",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "936-539-4031",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular & Interventional Radiology Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• Vascular & Interventional Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.