NPIMap

Organization Active NPI

Montgomery County Lung Clinic, P.a.

Doing business as None

  • Pulmonary Disease Physician
  • Conroe, TX
National Provider Identifier
1518065150
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
MONTGOMERY COUNTY LUNG CLINIC, P.A.
Doing business as
None
Practice address
110 Commercial Cir
Conroe, TX 77304-2204
Phone
(936) 756-2488
Fax
(936) 756-3686
NPI assigned
Sep 20, 2006
Last updated
Mar 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Authorized official

Name
Mr. Edward M Flores, M.D.NPI 1912922386
Title
President
Phone
(936) 756-2488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

110 Commercial Cir
Conroe, TX 77304-2204

Mailing address

110 Commercial Cir
Conroe, TX 77304-2204
Phone (936) 756-2488

Other identifiers 1

IdentifierTypeStateIssuer
093928201MedicaidTX

Other names 1

  • NONE Doing business as

National Provider Directory

National Provider Directory

Locations

110 Commercial Cir
Conroe, TX 77304
Phone (936) 756-2488

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1518065150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COMMERCIAL CIR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042204",
            "telephone_number": "936-756-2488",
            "fax_number": "936-756-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 COMMERCIAL CIR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042204",
            "telephone_number": "936-756-2488",
            "fax_number": "936-756-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY LUNG CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-756-2488",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093928201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NONE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 3, 2011; 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.