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NPI Code Detail

MEDICARE: VIVIAN CONROY

MEDICARE: VIVIAN CONROY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianPA62237CA
2363A00000XPhysician AssistantPA18528TX

General Provider Information

NPI Number : 1033827647
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIAN CONROY
Provider Business Mailing Address
First Line : 2920 TELEGRAPH AVE STE 100
Second Line :
City : BERKELEY
State : CA
Zip : 94705-2031
Country : US
Telephone Number : 415-329-3727
Fax Number :
Provider Business Practice Location Address
First Line : 3300 BEE CAVES RD STE 440
Second Line :
City : WEST LAKE HILLS
State : TX
Zip : 78746-6770
Country : US
Telephone Number : 512-399-0402
Fax Number : 844-460-2062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2022
Last Update Date : 03/04/2025

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Directions to “ VIVIAN CONROY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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