Provider Demographics
NPI:1356370282
Name:ATLIN, NEIL (DO)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:ATLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16800 DALLAS PKWY STE 190
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1957
Mailing Address - Country:US
Mailing Address - Phone:469-828-1692
Mailing Address - Fax:
Practice Address - Street 1:16800 DALLAS PKWY STE 190
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1957
Practice Address - Country:US
Practice Address - Phone:469-828-1692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0908174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE99966Medicare UPIN