Individual
JILL K. CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5939 HARRY HINES BLVD, SUITE 400, MAIL CODE 9191, DALLAS, TX 75390-9191
(214) 645-2422
(214) 645-2420
Mailing address
5939 HARRY HINES BLVD, SUITE 400, MAIL CODE 9191, DALLAS, TX 75390-9191
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04440
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180843801
—
TX
01
—
8N9852
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/03/2006
Last updated
03/04/2011
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