Provider Demographics
NPI:1023052974
Name:NEVILLE, ROBERT E (DPM)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:NEVILLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1120 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3242
Mailing Address - Country:US
Mailing Address - Phone:281-364-9041
Mailing Address - Fax:281-363-9712
Practice Address - Street 1:1120 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 180
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3242
Practice Address - Country:US
Practice Address - Phone:281-364-9041
Practice Address - Fax:281-363-9712
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX990213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT15024Medicare UPIN
TX00U71QMedicare ID - Type Unspecified