Provider Demographics
NPI:1659132546
Name:TECBEC INC A MEDICAL PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:TECBEC INC A MEDICAL PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-331-9620
Mailing Address - Street 1:PO BOX 872
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91376-0872
Mailing Address - Country:US
Mailing Address - Phone:818-518-7226
Mailing Address - Fax:818-671-2225
Practice Address - Street 1:15717 BELLE DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1439
Practice Address - Country:US
Practice Address - Phone:571-331-9620
Practice Address - Fax:818-671-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty