Provider Demographics
NPI:1649753682
Name:MCNEILL, CAITLIN BABCO (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:BABCO
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:BABCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:929 GESSNER RD STE 1600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2515
Practice Address - Country:US
Practice Address - Phone:713-442-5200
Practice Address - Fax:713-457-5188
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-14
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12297363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8PZ749OtherBCBS - BLUE STAR SURGICAL
TX8PZ750OtherBCBS - UNIVERSAL SURGICAL ASSISTANTS
TX8PX959OtherBCBS - US MSO
TX8PZ695OtherBCBS - UNIVERSAL SURGICAL PARTNERS
TX8PZ697OtherBCBS - XCITE SURGICAL
TXPA12297OtherTEXAS MEDICAL BOARD