Individual provider · Type 1 NPI
Jimmy Larue Conner, PA-C
Medical Physician Assistant · San Antonio, TX
NPI number
1497142160
Active
Practice location
2903 Deer Ledge
San Antonio, TX 78230-4554
Fax (210) 979-8274
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA00612 (TX) |
Medical Physician Assistant: Definition to come...
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About NPI 1497142160
Jimmy Larue Conner, PA-C's National Provider Identifier is 1497142160, issued on Apr 21, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in San Antonio, TX. The record was last updated on Apr 21, 2015.