Organization Active NPI

Conroe Intensivist Group LLC

  • Pulmonary Disease Physician
  • Conroe, TX
National Provider Identifier
1407527807
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
CONROE INTENSIVIST GROUP LLC
Practice address
504 Medical Center Blvd Ste 300
Conroe, TX 77304-2808
Phone
(936) 703-5970
Fax
(936) 776-3010
NPI assigned
Sep 24, 2021
Last updated
Sep 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Authorized official

Name
Mrs. Christina Danes
Title
Manger
Phone
(936) 499-5318

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU Primary
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

504 Medical Center Blvd Ste 300
Conroe, TX 77304-2808

Mailing address

504 Medical Center Blvd Ste 300
Conroe, TX 77304-2808
Phone (936) 703-5970

National Provider Directory

National Provider Directory

Locations

504 Medical Center Blvd
#300
Conroe, TX 77304
Phone (936) 230-5358

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632441600000",
    "number": "1407527807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 MEDICAL CENTER BLVD STE 300",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042808",
            "telephone_number": "936-703-5970",
            "fax_number": "936-776-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 MEDICAL CENTER BLVD STE 300",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042808",
            "telephone_number": "936-703-5970",
            "fax_number": "936-776-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROE INTENSIVIST GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A",
        "authorized_official_last_name": "DANES",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "MANGER",
        "authorized_official_telephone_number": "936-499-5318",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.