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NPI Code Detail

MEDICARE: AUNDRA LAVON CONYER

MEDICARE: AUNDRA LAVON CONYER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1508321274
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUNDRA LAVON CONYER
Provider Business Mailing Address
First Line : 3615 CULEBRA RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228-5914
Country : US
Telephone Number : 210-314-6473
Fax Number :
Provider Business Practice Location Address
First Line : 3615 CULEBRA RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228-5914
Country : US
Telephone Number : 210-314-6473
Fax Number : 210-314-8676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2019
Last Update Date : 02/06/2019

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Directions to “ AUNDRA LAVON CONYER ” Practice Location

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