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General NPI Number Information
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NPI Number | 1700376456
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Entity Type | Individual
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Provider Name | CONNER JAY MCNABB OD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2018
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 810 KNIGHTS CROSS DR STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 210-831-0257
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Fax | 210-495-9398
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Provider Business Mailing Address
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Address Line | 810 KNIGHTS CROSS DR STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258-2981
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Country | US
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Telephone | 210-495-9020
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Fax | 210-495-9398
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9463T
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License Number State | TX
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