Provider Demographics
NPI:1932867249
Name:BORMANS, CONCETTA (PHD)
Entity Type:Individual
Prefix:
First Name:CONCETTA
Middle Name:
Last Name:BORMANS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CONCETTA
Other - Middle Name:
Other - Last Name:CONAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1445 NORTH LOOP W STE 820
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1673
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1445 NORTH LOOP W STE 820
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1673
Practice Address - Country:US
Practice Address - Phone:713-868-1438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics