Individual
MR. JIMMY LARUE CONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2903 DEER LEDGE, SAN ANTONIO, TX 78230-4554
(210) 213-1817
(210) 979-8274
Mailing address
2903 DEER LEDGE, SAN ANTONIO, TX 78230-4554
(210) 213-1817
(210) 979-8274
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00612
TX
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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