Provider Demographics
NPI:1811518624
Name:NEVILLE, AUSTEN ROBERT (DPM)
Entity type:Individual
Prefix:DR
First Name:AUSTEN
Middle Name:ROBERT
Last Name:NEVILLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 SILVER IRIS WAY
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2714
Mailing Address - Country:US
Mailing Address - Phone:832-477-6639
Mailing Address - Fax:
Practice Address - Street 1:1401 ST JOSEPH PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8301
Practice Address - Country:US
Practice Address - Phone:713-756-8217
Practice Address - Fax:713-657-7234
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program