Provider Demographics
NPI:1407978398
Name:ROBERT S. CONRAD,D.D.S.,P.A.
Entity Type:Organization
Organization Name:ROBERT S. CONRAD,D.D.S.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARENDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOGUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-468-2936
Mailing Address - Street 1:800 GESSNER RD
Mailing Address - Street 2:250
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4276
Mailing Address - Country:US
Mailing Address - Phone:713-468-2936
Mailing Address - Fax:713-465-6957
Practice Address - Street 1:800 GESSNER RD
Practice Address - Street 2:250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4276
Practice Address - Country:US
Practice Address - Phone:713-468-2936
Practice Address - Fax:713-465-6957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX153961223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty