# THERESA M. CONYAC MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GLOW
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497263552
- **Authorized official:** DR. THERESA M CONYAC MD (OWNER, MD)
- **Authorized official phone:** (972) 722-2526

## Contact information

- **Practice address:** 6705 HERITAGE PARKWAY, SUITE 102, ROCKWALL, TX 75087-8749
- **Practice address phone:** (972) 722-2526
- **Practice address fax:** (972) 722-2528
- **Mailing address:** 6705 HERITAGE PARKWAY, SUITE 102, ROCKWALL, TX 75087-8749
- **Mailing address phone:** (972) 722-2526
- **Mailing address fax:** (972) 722-2528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | P8875 | TX | Yes |

## Other

- **Enumeration date:** 01/11/2018
- **Last updated:** 08/26/2019