Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | S3029 | TX |
N | 111NI0900X | Internist | S3029 | TX |
Y | 207RI0011X | Interventional Cardiology | S3029 | TX |
NPI | 1023373545 |
---|---|
Provider Name | Dr. Farley Berry Graden Neasman III |
First Address | Abilene, TX 79606-5247 |
Second Address | Abilene, TX 79606-5260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2012 |
Last Update Date | 06/11/2020 |