Basic Information
Provider Information
NPI: 1760673941
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CONLON
FirstName: JULIA
MiddleName: TERESA
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 841969
Address2:  
City: DALLAS
State: TX
PostalCode: 752841521
CountryCode: US
TelephoneNumber: 8328242999
FaxNumber:  
Practice Location
Address1: 2450 FONDREN RD
Address2: SUITE 310
City: HOUSTON
State: TX
PostalCode: 770632318
CountryCode: US
TelephoneNumber: 7137817907
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/05/2007
LastUpdateDate: 02/07/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XN4993TXY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


Home