Provider Demographics
NPI:1649575622
Name:DUNLEAVY, NEIL CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:CHRISTOPHER
Last Name:DUNLEAVY
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 1:17270 RED OAK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2618
Mailing Address - Country:US
Mailing Address - Phone:281-440-6960
Mailing Address - Fax:281-440-6205
Practice Address - Street 1:17270 RED OAK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2618
Practice Address - Country:US
Practice Address - Phone:281-440-6960
Practice Address - Fax:281-440-6205
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8892207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX359286YSX9Medicare PIN