Provider Demographics
NPI:1093020117
Name:MCCONKEY, ROSABELLE VIA (MD)
Entity Type:Individual
Prefix:
First Name:ROSABELLE
Middle Name:VIA
Last Name:MCCONKEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1259 FM 1463 RD STE 300
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5474
Mailing Address - Country:US
Mailing Address - Phone:832-856-4600
Mailing Address - Fax:
Practice Address - Street 1:1259 FM 1463 RD STE 300
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5474
Practice Address - Country:US
Practice Address - Phone:832-856-4600
Practice Address - Fax:281-665-3969
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN45792080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine