Provider Demographics
NPI:1851614580
Name:ALAN MOBLEY MD PA
Entity Type:Organization
Organization Name:ALAN MOBLEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-756-5866
Mailing Address - Street 1:600 RIVER POINTE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2867
Mailing Address - Country:US
Mailing Address - Phone:936-756-5866
Mailing Address - Fax:936-756-5703
Practice Address - Street 1:600 RIVER POINTE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2867
Practice Address - Country:US
Practice Address - Phone:936-756-5866
Practice Address - Fax:936-756-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7846207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115630902Medicaid
TX00NB55Medicare PIN