Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | L6541 | TX |
N | 2080P0201X | Pediatric Allergist | L6541 | TX |
NPI | 1326009614 |
---|---|
Provider Name | William Allen Neaville |
First Address | Dallas, TX 75234-7845 |
Second Address | Dallas, TX 75234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 28/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
159167901 | (05) | TX |
159167903 | (05) | TX |
H87685 | (02) |