MEDICARE: CONAC MEDICAL RESOURCES

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
1	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1972753523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONAC MEDICAL RESOURCES

Provider Business Mailing Address
First Line	:	2639 WALNUT HILL LN STE 127
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-5688
Country	:	US
Telephone Number	:	214-350-2239
Fax Number	:	214-350-0670

Provider Business Practice Location Address
First Line	:	2639 WALNUT HILL LANE
Second Line	:	SUITE 127
City	:	DALLAS
State	:	TX
Zip	:	75229
Country	:	US
Telephone Number	:	214-350-2239
Fax Number	:	214-350-0670

Authorized Official
Title or Position	:	PATNER
Name	:	MRS. OBIAGERI NWABUEZE
Credential	:
Telephone Number	:	214-350-2239

Provider Enumeration Date	:	09/19/2008
Last Update Date	:	05/12/2010

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