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General NPI Number Information
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NPI Number | 1063980316
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Entity Type | Individual
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Provider Name | CONNIE B MCCOY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/05/2018
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 7901 SW 34TH AVE
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City | AMARILLO
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State | TX
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Zip | 79121-1057
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Country | US
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Telephone | 806-350-7918
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Fax | 806-418-8982
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Provider Business Mailing Address
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Address Line | 2000 S MAYS ST STE 201
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City | ROUND ROCK
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State | TX
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Zip | 78664-7580
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Country | US
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Telephone | 512-244-4272
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Fax | 806-665-8503
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP139633
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License Number State | TX
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