Provider Demographics
NPI:1245215151
Name:CONKLIN, GEORGE T (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:T
Last Name:CONKLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1200 BINZ ST
Mailing Address - Street 2:STE 700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6900
Mailing Address - Country:US
Mailing Address - Phone:713-797-9191
Mailing Address - Fax:713-986-1262
Practice Address - Street 1:1200 BINZ ST
Practice Address - Street 2:STE 700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6900
Practice Address - Country:US
Practice Address - Phone:713-797-9191
Practice Address - Fax:713-986-1262
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD9107207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX820051Medicare PIN
TXB21955Medicare UPIN
TX8J7324Medicare PIN