Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | J2706 | TX |
NPI | 1114016839 |
---|---|
Provider Name | Charles Edward Neagle |
First Address | Carrollton, TX 75010-4615 |
Second Address | Carrollton, TX 75010-4615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 01/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6484850003 | MEDICARE NSC - EFFECT 02/01/2011 (01) | TX |
8B7876 | BLUE CROSS BLUE SHIELD (01) | TX |
8CR161 | BCBS TX 02/01/2011 (01) | TX |
98971704 | (05) | TX |
F37153 | (02) | TX |
P00913358 | MEDICARE RAILROAD - EFFECT 02/01/2011 (01) | TX |
TXB117510 | MEDICARE PART B - EFFECT 02/01/2011 (01) | TX |