Provider Demographics
NPI:1710216841
Name:KONING, JONATHAN CONRAD (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CONRAD
Last Name:KONING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 W PARKER RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8177
Mailing Address - Country:US
Mailing Address - Phone:469-252-4777
Mailing Address - Fax:469-518-2156
Practice Address - Street 1:6020 W PARKER RD STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8177
Practice Address - Country:US
Practice Address - Phone:469-252-4777
Practice Address - Fax:469-518-2156
Is Sole Proprietor?:No
Enumeration Date:2009-12-20
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0953207L00000X, 207LP2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine