Individual
JACK AUTREY CONOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1195 GARNER FIELD RD, SUITE 300, UVALDE, TX 78801-4820
(830) 278-3086
Mailing address
1195 GARNER FIELD RD, SUITE 300, UVALDE, TX 78801-4820
(830) 278-3086
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
N5635
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
N5635
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N5635
STATE LICENSE
TX
Enumeration date
04/22/2007
Last updated
11/17/2016
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