Provider Demographics
NPI:1255738043
Name:CONWAY THERAPEUTICS, PLLC
Entity type:Organization
Organization Name:CONWAY THERAPEUTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:615-832-5530
Mailing Address - Street 1:330 WALLACE RD
Mailing Address - Street 2:SUITE103
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4893
Mailing Address - Country:US
Mailing Address - Phone:615-832-5530
Mailing Address - Fax:615-832-5713
Practice Address - Street 1:330 WALLACE RD
Practice Address - Street 2:SUITE103
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4893
Practice Address - Country:US
Practice Address - Phone:615-832-5530
Practice Address - Fax:615-832-5713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-23
Last Update Date:2014-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000016892261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical