1639373459 NPI number — NETWORK IMAGING PLLC

Table of content: D'ARCY MARIE CONLEY LCPC (NPI 1306991260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639373459 NPI number — NETWORK IMAGING PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NETWORK IMAGING PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639373459
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
206A S LOOP 336 W # 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONROE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77304-3300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
936-441-7227
Provider Business Mailing Address Fax Number:
936-756-9729

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
206A S LOOP 336 W # 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONROE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77304-3300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-441-7227
Provider Business Practice Location Address Fax Number:
936-756-9729
Provider Enumeration Date:
06/14/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARMON
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
936-441-7227

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)