Connally, Jack D

Connally, Jack D is an sole proprietor health care provider with primary practice located at 10500 Steppington Dr Suite 100A, Dallas TX 75230-4561. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Connally, Jack D can be contacted via phone (214) 987-4601.

Contact Information

Primary practice address
10500 Steppington Dr Suite 100A Dallas TX 75230-4561
Phone: (214) 987-4601
Fax: (214) 987-4039
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X E0425 Texas

Profile Details

NPI number 1023002755
LBN Legal business name Connally, Jack D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 8th, 2005
Last updated Jan 12th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023002755 NPPES
Texas MEDICAID 134250301

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