Organization
CONROE FAMILY MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK PIENIAZEK DO (PHYSICIAN)
(936) 756-6661
Entity
Organization
Contact information
Practice address
3205 W DAVIS ST, STE B150, CONROE, TX 77304-2066
(936) 756-6661
(936) 756-6681
Mailing address
3205 W DAVIS ST, STE B150, CONROE, TX 77304-2066
(936) 756-6661
(936) 756-6681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K0541
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145630301
—
TX
Enumeration date
06/09/2005
Last updated
04/22/2008
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