Provider Demographics
NPI:1417047721
Name:MCANELLY, GEORGE II (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:MCANELLY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 E SANDY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3019
Mailing Address - Country:US
Mailing Address - Phone:972-304-9240
Mailing Address - Fax:972-745-3382
Practice Address - Street 1:652 E SANDY LAKE RD
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-3019
Practice Address - Country:US
Practice Address - Phone:972-304-9240
Practice Address - Fax:972-745-3382
Is Sole Proprietor?:No
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5109208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics