Provider Demographics
NPI:1447606553
Name:NEUMAN, JAVIER (SA-C)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:NEUMAN
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 N PEAK ST APT 7200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6704
Mailing Address - Country:US
Mailing Address - Phone:972-325-4243
Mailing Address - Fax:
Practice Address - Street 1:1333 N PEAK ST APT 7200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6704
Practice Address - Country:US
Practice Address - Phone:972-325-4243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16-311246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant