| NAME |
CONROE CBOC |
| STATE |
TEXAS |
| STREET ADDR. 1 |
690 SOUTH LOOP 336 WEST, SUITE 300 |
| CITY |
CONROE |
| ZIP |
77304-3320 |
| OFFICIAL VA NAME |
CONROE CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CONROE VA CLINIC |
| ST. ADDR. 1 (MAILING) |
690 SOUTH LOOP 336 WEST, SUITE 300 |
| CITY (MAILING) |
CONROE |
| STATE (MAILING) |
TEXAS |
| ZIP (MAILING) |
77304-3320 |
| EFFECTIVE DATE/TIME |
-
- 2007-10-29 00:00:00
- STATUS: ACTIVE
- NPI: 1073637112
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
580GD |
| IDENTIFIER |
-
- CODING SYSTEM: CLIA
- ID: 45D1081765
|
