Healthcare Provider Details

I. General information

NPI: 1053931345
Provider Name (Legal Business Name): ANNA ELIZABETH O'CONNOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E MAIN ST
ROUND ROCK TX
78664-5246
US

IV. Provider business mailing address

303 E MAIN ST
ROUND ROCK TX
78664-5246
US

V. Phone/Fax

Practice location:
  • Phone: 512-732-2774
  • Fax: 512-344-9221
Mailing address:
  • Phone: 512-732-2774
  • Fax: 512-344-9221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV7268
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberV7268
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: