Provider Demographics
NPI:1568968634
Name:CONNORS, TRISSA MCCLATCHEY (MD)
Entity Type:Individual
Prefix:
First Name:TRISSA
Middle Name:MCCLATCHEY
Last Name:CONNORS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TRISSA
Other - Middle Name:MARIE
Other - Last Name:MCCLATCHEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:484-476-2000
Mailing Address - Fax:
Practice Address - Street 1:4603 FM 1463 RD STE 100
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6846
Practice Address - Country:US
Practice Address - Phone:281-612-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT6212207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology