Conroe Family Medicine, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K0541 Issued in TX

Legal business name

CONROE FAMILY MEDICINE, PA

Practice address

3205 W Davis St
Ste B150
Conroe, TX 77304-2066

Phone

(936) 756-6661

Fax

(936) 756-6681

NPI assigned

Jun 9, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Jack Pieniazek, DO

Title

Physician

Phone

(936) 756-6661

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1811991524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 W DAVIS ST",
            "address_2": "STE B150",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042066",
            "telephone_number": "936-756-6661",
            "fax_number": "936-756-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 W DAVIS ST",
            "address_2": "STE B150",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042066",
            "telephone_number": "936-756-6661",
            "fax_number": "936-756-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROE FAMILY MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "PIENIAZEK",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "936-756-6661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K0541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145630301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conroe Eye Clinic, LLP
• Conroe Eye Clinic, LLP
• Conroe Eyes
• Conroe Family Dentistry PLLC
• Conroe Family Doctor PLLC
• Conroe Fsed LLC
• Conroe Home Medical Equipment, Inc
• Conroe Independent School District
• Conroe Intensivist Group LLC
• Conroe MC Partners, LP

• Family Medicine Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.