Provider Demographics
NPI:1811939820
Name:CONNOR, RONALD WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:WAYNE
Last Name:CONNOR
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 1:400 CONCORD PLAZA DR
Mailing Address - Street 2:300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6905
Mailing Address - Country:US
Mailing Address - Phone:210-396-5300
Mailing Address - Fax:210-804-5444
Practice Address - Street 1:150 E SONTERRA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4184
Practice Address - Country:US
Practice Address - Phone:210-396-5300
Practice Address - Fax:210-804-5444
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4057207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122233306Medicaid
TX5082488OtherAETNA
TX200042346OtherRAILROAD MEDICARE
TX8B8392OtherBCBS
TX4123547OtherCIGNA
TX5082488OtherAETNA
TX8B8392OtherBCBS