Basic Information
| Provider Information | |||||||||
| NPI: | 1447770953 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITED MEDICAL ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 MEDICAL CENTER BLVD STE 240 | ||||||||
| Address2: | |||||||||
| City: | CONROE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773042800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133606857 | ||||||||
| FaxNumber: | 7135831113 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 MEDICAL CENTER BLVD STE 240 | ||||||||
| Address2: | |||||||||
| City: | CONROE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773042800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133606857 | ||||||||
| FaxNumber: | 7135831113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | BAILEY | ||||||||
| AuthorizedOfficialFirstName: | JASON | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7133606857 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | Q5375 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.