Provider Demographics
NPI:1609064310
Name:MCNEILL, SCOTT SHAW (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:SHAW
Last Name:MCNEILL
Suffix:
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 1:408 NAVARRO ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2502
Mailing Address - Country:US
Mailing Address - Phone:210-272-1741
Mailing Address - Fax:210-272-1747
Practice Address - Street 1:408 NAVARRO ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2502
Practice Address - Country:US
Practice Address - Phone:210-272-1741
Practice Address - Fax:210-272-1747
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7058207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine