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NPI Code Detail

MEDICARE: SALLY A CONNAUGHTON

MEDICARE:   SALLY A CONNAUGHTON
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
1246ZS0410XSurgical Technologist104146TX

General Provider Information

NPI Number : 1710192224
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY A CONNAUGHTON
Provider Business Mailing Address
First Line : 3322 COLORADO BLVD
Second Line : SUITE 101
City : DENTON
State : TX
Zip : 76210-6864
Country : US
Telephone Number : 940-387-7588
Fax Number : 940-566-0881
Provider Business Practice Location Address
First Line : 3322 COLORADO BLVD
Second Line : SUITE 101
City : DENTON
State : TX
Zip : 76210-6864
Country : US
Telephone Number : 940-387-7588
Fax Number : 940-566-0881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 11/06/2009

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Directions to “ SALLY A CONNAUGHTON ” Practice Location

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