Organization
MEDCONMD1 PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COURTNEY ANNELL CHAVIS (PRACTICE ADMINISTRATOR)
(469) 606-9090
Entity
Organization
Contact information
Practice address
505 E US HIGHWAY 80, FORNEY, TX 75126-8671
(844) 391-7277
(512) 857-1634
Mailing address
PO BOX 935, FORNEY, TX 75126-0935
(844) 391-7277
(512) 857-1634
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
02/23/2017
Last updated
05/08/2024
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