Healthcare Provider Details

I. General information

NPI: 1184152712
Provider Name (Legal Business Name): DEVIN LEE CONWAY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2017
Last Update Date: 09/12/2025
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W 34TH ST STE 101
AUSTIN TX
78705-1916
US

IV. Provider business mailing address

7505 N LOOP 1604 E STE 101
LIVE OAK TX
78233-2604
US

V. Phone/Fax

Practice location:
  • Phone: 512-302-3921
  • Fax:
Mailing address:
  • Phone: 210-590-4000
  • Fax: 210-590-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberT16075
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: