Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | J1864 | TX |
NPI | 1336256312 |
---|---|
Provider Name | Deborah L. Conway |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78207-3110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 29/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102467103 | (05) | TX |