Provider Demographics
NPI:1184186058
Name:HARGIS, CONNER RAY (PA)
Entity Type:Individual
Prefix:
First Name:CONNER
Middle Name:RAY
Last Name:HARGIS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13603 MICHEL RD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6410
Mailing Address - Country:US
Mailing Address - Phone:281-803-3246
Mailing Address - Fax:281-378-7726
Practice Address - Street 1:13603 MICHEL RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6410
Practice Address - Country:US
Practice Address - Phone:281-803-3246
Practice Address - Fax:281-378-7726
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12711207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery