Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sam Houston State University

Organization Neuromusculoskeletal Medicine & OMM Physician · NPI 1942850565

Sam Houston State University is a Neuromusculoskeletal Medicine & OMM Physician in Conroe, Texas. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
7

Practice location Address checks out

1169 Grand Central Pkwy
Conroe, TX 77304-3185
Phone: (936) 525-3600
Fax: (936) 525-3624
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Neuromusculoskeletal Medicine & OMM Physician Taxonomy 204D00000X
Family Medicine Physician Taxonomy 207Q00000X
Sports Medicine (Family Medicine) Physician Taxonomy 207QS0010X
Internal Medicine Physician Taxonomy 207R00000X
Pediatrics Physician Taxonomy 208000000X
Pediatric Hematology & Oncology Physician Taxonomy 2080P0207X

Record details

NPI number1942850565
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSam Houston State University
Authorized official Amanda Withers — Cfo And Sr Vp For Operations · (936) 294-2686
NPI enumeratedSeptember 16, 2019
Last updated in NPPESOctober 7, 2024
Certification dateOctober 7, 2024
Mailing address1169 Grand Central Pkwy, Conroe, TX 77304-3185

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