Provider Demographics
NPI:1386034866
Name:HOBEN MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:HOBEN MEDICAL ASSOCIATES
Other - Org Name:HOBEN SURGICAL ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JONAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KONAN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:832-647-1910
Mailing Address - Street 1:2261 NORTHPARK DR
Mailing Address - Street 2:BOX 518
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1744
Mailing Address - Country:US
Mailing Address - Phone:832-647-1910
Mailing Address - Fax:
Practice Address - Street 1:2261 NORTHPARK DR
Practice Address - Street 2:BOX 518
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1744
Practice Address - Country:US
Practice Address - Phone:832-647-1910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06898363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG97431Medicare UPIN