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Individual

CHARLES G CONNOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
9725 DATAPOINT DR, SAN ANTONIO, TX 78229-2384
(210) 283-6824
(210) 283-6890
Mailing address
9725 DATAPOINT DR, SAN ANTONIO, TX 78229-2384
(210) 283-6824
(210) 283-6890

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1238
TN
152W00000X
Optometrist
Primary
7934
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1238
OD
TN
05
3597523
TN
Enumeration date
08/24/2005
Last updated
11/11/2014
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