Provider Demographics
NPI:1992764922
Name:CONNER, BLAIR (MD)
Entity type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:
Last Name:CONNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7610 STEMMONS FWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4231
Mailing Address - Country:US
Mailing Address - Phone:214-689-5960
Mailing Address - Fax:214-630-7293
Practice Address - Street 1:411 N WASHINGTON AVE
Practice Address - Street 2:SUITE 6000
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:214-821-5266
Practice Address - Fax:214-821-0459
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6384207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132320607Medicaid
TX81503KOtherBCBSTX
TX132320607Medicaid
TX110213448Medicare PIN
TX81503KOtherBCBSTX