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NPI Code Detail

MEDICARE: PATRICK A CONWAY DO

MEDICARE: PATRICK A CONWAY DO
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
1207Q00000XFamily Medicine PhysicianL1008TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487688594
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK A CONWAY DO
Provider Business Mailing Address
First Line : 7001 GRANBURY RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76133-5912
Country : US
Telephone Number : 817-346-1925
Fax Number : 817-292-7237
Provider Business Practice Location Address
First Line : 7001 GRANBURY RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76133-5912
Country : US
Telephone Number : 817-346-1925
Fax Number : 817-292-7237
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 04/04/2012

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