Provider Demographics
NPI:1295316933
Name:DOWNHAM, GEORGE A (DO)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:A
Last Name:DOWNHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S CONROE MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-4722
Mailing Address - Country:US
Mailing Address - Phone:936-539-4004
Mailing Address - Fax:936-539-3635
Practice Address - Street 1:3251 I H 45 N STE 100
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2185
Practice Address - Country:US
Practice Address - Phone:936-441-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT8804207Q00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine