Individual
DR. JACK D CONNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10500 STEPPINGTON DR, SUITE 100A, DALLAS, TX 75230-4561
(214) 987-4601
(214) 987-4039
Mailing address
10500 STEPPINGTON DR, DALLAS, TX 75230-4560
(214) 987-4601
(214) 987-4039
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E0425
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134250301
—
TX
Enumeration date
09/08/2005
Last updated
01/12/2010
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