Provider Demographics
NPI:1972753523
Name:CONAC MEDICAL RESOURCES
Entity Type:Organization
Organization Name:CONAC MEDICAL RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OBIAGERI
Authorized Official - Middle Name:
Authorized Official - Last Name:NWABUEZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-350-2239
Mailing Address - Street 1:2639 WALNUT HILL LN STE 127
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5688
Mailing Address - Country:US
Mailing Address - Phone:214-350-2239
Mailing Address - Fax:214-350-0670
Practice Address - Street 1:2639 WALNUT HILL LANE
Practice Address - Street 2:SUITE 127
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229
Practice Address - Country:US
Practice Address - Phone:214-350-2239
Practice Address - Fax:214-350-0670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6314740001Medicare NSC