Provider Demographics
NPI:1407243959
Name:MCDANIEL, CONNER (MD)
Entity Type:Individual
Prefix:
First Name:CONNER
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:221 W COLORADO BLVD STE 425
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2312
Mailing Address - Country:US
Mailing Address - Phone:214-947-3231
Mailing Address - Fax:214-947-3239
Practice Address - Street 1:221 W COLORADO BLVD STE 425
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2312
Practice Address - Country:US
Practice Address - Phone:214-947-3231
Practice Address - Fax:214-947-3239
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS64492086S0127X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty