Individual
DR. ROBERT CRISP CONNALLY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17218 PRESTON RD STE 2000, DALLAS, TX 75252-4018
(877) 866-7123
Mailing address
PO BOX 742712, ATLANTA, GA 30374-2712
(877) 866-7123
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
T3937
TX
208D00000X
General Practice Physician
T3937
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433865901
—
TX
Enumeration date
04/01/2017
Last updated
07/25/2023
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