Healthcare Provider Details

I. General information

NPI: 1942697149
Provider Name (Legal Business Name): CONOR WILLIAM BYRT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2015
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21731 SOUND WAY 102
ESTERO FL
33928
US

IV. Provider business mailing address

9181 TOWN SQUARE BLVD APT 2324
AMARILLO TX
79119-1235
US

V. Phone/Fax

Practice location:
  • Phone: 518-269-6139
  • Fax:
Mailing address:
  • Phone: 518-269-6139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number6771968
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number306345
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: