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General NPI Number Information
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NPI Number | 1023373545
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Entity Type | Individual
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Provider Name | FARLEY BERRY GRADEN NEASMAN III M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 6200 REGIONAL PLZ STE 1675
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City | ABILENE
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State | TX
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Zip | 79606-5260
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Country | US
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Telephone | 325-428-4790
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Fax | 325-428-5855
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Provider Business Mailing Address
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Address Line | 1680 ANTILLEY RD STE 270
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City | ABILENE
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State | TX
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Zip | 79606-5247
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Country | US
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Telephone | 325-428-4790
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Fax | 325-428-5855
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | S3029
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | S3029
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License Number State | TX
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