Provider Demographics
NPI:1871644021
Name:NEEB, DAVID E (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:E
Last Name:NEEB
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2265
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79105-2265
Mailing Address - Country:US
Mailing Address - Phone:806-355-9595
Mailing Address - Fax:
Practice Address - Street 1:6819 PLUM CREEK DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1602
Practice Address - Country:US
Practice Address - Phone:806-355-9595
Practice Address - Fax:806-353-1589
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS55541367500000X
TX221949367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS145394OtherBCBS OF KS
KS200419030AMedicaid
P00398987OtherRR MEDICARE GROUP CQ25302
TXTXB149420Medicare PIN
KS145394OtherBCBS OF KS
P00398987OtherRR MEDICARE GROUP CQ25302