Sam Houston State University

Specialty details in registry · Conroe, TX

Call (936) 525-3600 Directions

At a glance

1169 Grand Central Pkwy, Conroe, TX 77304-3185

NPPES record updated Sep 1, 2026. Public records can lag behind changes at a practice.

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Practice location

1169 Grand Central Pkwy
Conroe, TX 77304-3185

Professional details: NPI, taxonomy & registry record

NPI1942850565

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 261QM1300X
Enumeration date: Sep 16, 2019
Record updated: Sep 1, 2026

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

204D00000X

Family Medicine

207Q00000X

Specialty details in registry

207QS0010X

Internal Medicine

207R00000X

Pediatrics

208000000X

Specialty details in registry

2080P0207X

Specialty details in registry

261QM1300X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1169 Grand Central Pkwy
Conroe, TX 77304-3185

Phone: (936) 525-3600
Fax: (936) 525-3624

Mailing address

1169 GRAND CENTRAL PKWY

CONROE, TX 773043185

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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