Provider Demographics
NPI:1588049613
Name:CONARD, YVONNE (PA-C)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:CONARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 MUNGER AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-4421
Mailing Address - Country:US
Mailing Address - Phone:415-710-0585
Mailing Address - Fax:
Practice Address - Street 1:2650 CEDAR SPRINGS RD
Practice Address - Street 2:#5535
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-1495
Practice Address - Country:US
Practice Address - Phone:415-710-0585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09863363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical