Basic Information
Provider Information
NPI: 1407062102
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CONROY
FirstName: STEVEN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6300 LA CALMA DR
Address2: SUITE 200
City: AUSTIN
State: TX
PostalCode: 787523843
CountryCode: US
TelephoneNumber: 5124528533
FaxNumber: 5124526685
Practice Location
Address1: 6300 LA CALMA DR
Address2: SUITE 200
City: AUSTIN
State: TX
PostalCode: 787523843
CountryCode: US
TelephoneNumber: 5124528533
FaxNumber: 5124526685
Other Information
ProviderEnumerationDate: 05/16/2007
LastUpdateDate: 03/14/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XOT010837PAN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XN3574TXY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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