Provider Demographics
NPI:1619322492
Name:DOCTOR, NEIL
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:DOCTOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 W LOOP 250 N STE A
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-3205
Mailing Address - Country:US
Mailing Address - Phone:432-218-8054
Mailing Address - Fax:432-218-6487
Practice Address - Street 1:2817 W LOOP 250 N STE A
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-3205
Practice Address - Country:US
Practice Address - Phone:432-218-8054
Practice Address - Fax:432-218-6487
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7040207L00000X, 208VP0014X
TXBP20060838207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology