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Individual
PATRICIA AILEEN CONNALLY
Active
Individual
PATRICIA AILEEN CONNALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
43258
CO
207Q00000X
Family Medicine Physician
625OA
WY
207Q00000X
Family Medicine Physician
Primary
P5789
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120609500
—
WY
05
—
336109901
—
TX
05
—
336109903
—
TX
05
—
50139525
—
CO
01
—
8EG745
BCBS
TX
01
—
8EL431
BCBS
TX
01
—
P01527360
RAILROAD MEDICARE
TX
Enumeration date
11/21/2005
Last updated
12/04/2015
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