Provider Demographics
NPI:1336182310
Name:BEALKA, NEIL MICHAEL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:MICHAEL
Last Name:BEALKA
Suffix:JR
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 1:2406 S BUSINESS HWY 36
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528
Mailing Address - Country:US
Mailing Address - Phone:254-865-4267
Mailing Address - Fax:254-865-8293
Practice Address - Street 1:2406 S BUSINESS HWY 36
Practice Address - Street 2:
Practice Address - City:GATESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76528
Practice Address - Country:US
Practice Address - Phone:254-865-4267
Practice Address - Fax:254-865-8293
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3044207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133678606Medicaid
TX133678608Medicaid
TX8246M0OtherBLUE CROSS
TX141555601Medicaid
TX8246M0Medicare PIN
TX00069RMedicare ID - Type Unspecified
TX8524J0Medicare PIN
TX180038614Medicare PIN
TX141555601Medicaid
TXD26424Medicare UPIN