Organization
ILACONE GROUP INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER G JOE MD, MBA (PRESIDENT)
(832) 345-8141
Entity
Organization
Contact information
Practice address
2121 BUSINESS CENTER DR, PEARLAND, TX 77584-2153
(346) 907-3000
Mailing address
PO BOX 1537, SUGAR LAND, TX 77487-1537
(346) 200-5909
(346) 200-5660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
P4322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12474223
CAQH
—
Enumeration date
03/12/2013
Last updated
02/21/2025
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