Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 990 | TX |
NPI | 1023052974 |
---|---|
Provider Name | Dr. Robert E Neville |
First Address | The Woodlands, TX 77380-3242 |
Second Address | The Woodlands, TX 77380-3242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 07/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T15024 | (02) | TX |