Theresa M. Conyac MD PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

P8875 Issued in TX

Legal business name

THERESA M. CONYAC MD PLLC

Doing business as

Glow

Practice address

6705 Heritage Parkway
Suite 102
Rockwall, TX 75087-8749

Phone

(972) 722-2526

Fax

(972) 722-2528

NPI assigned

Jan 11, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Theresa M Conyac, MDNPI 1598965188

Title

Owner, MD

Phone

(972) 722-2526

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• GLOW Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17269/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theresa Conyac, M.D.

  • Obstetrics & Gynecology Physician
  • Rockwall, TX
  • NPI 1598965188
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1497263552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 HERITAGE PARKWAY",
            "address_2": "SUITE 102",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750878749",
            "telephone_number": "972-722-2526",
            "fax_number": "972-722-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6705 HERITAGE PARKWAY",
            "address_2": "SUITE 102",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750878749",
            "telephone_number": "972-722-2526",
            "fax_number": "972-722-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA M. CONYAC MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "CONYAC",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER, MD",
        "authorized_official_telephone_number": "972-722-2526",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P8875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598965188",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLOW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Obstetrics & Gynecology Physician in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.