Provider Demographics
NPI:1801887864
Name:CONNER, WILLIAM CHANCE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHANCE
Last Name:CONNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1010 W 40TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-4010
Mailing Address - Country:US
Mailing Address - Phone:512-459-8753
Mailing Address - Fax:
Practice Address - Street 1:1010 W 40TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4010
Practice Address - Country:US
Practice Address - Phone:512-459-8753
Practice Address - Fax:512-651-8441
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2291208G00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX336839101Medicaid
TX336839101Medicaid