Provider Demographics
NPI:1437331139
Name:ONXLEY, CONNIE (LMT)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:ONXLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 HIGHWAY 332 W
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4013
Mailing Address - Country:US
Mailing Address - Phone:979-236-9976
Mailing Address - Fax:
Practice Address - Street 1:206 HIGHWAY 332 W
Practice Address - Street 2:SUITE A
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4013
Practice Address - Country:US
Practice Address - Phone:979-236-9976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLMT026170174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist