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General NPI Number Information
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NPI Number | 1760667802
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Entity Type | Organization
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Legal Business Name | JOHN LEE MCNEILL, DO, PA
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 11/14/2012
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Provider Practice Location Address
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Address Line | 3002 SAM HOUSTON DR.
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City | VICTORIA
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State | TX
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Zip | 77904
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Country | US
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Telephone | 361-578-3363
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Fax | 361-578-0749
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Provider Business Mailing Address
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Address Line | PO BOX 4348
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City | VICTORIA
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State | TX
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Zip | 77903-4348
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Country | US
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Telephone | 361-576-3680
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Fax | 361-578-0749
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Authorized Official
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Title or Position | OWNER
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Name | JOHN L MCNEILL
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Credential | D.O.
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Telephone | 361-576-3680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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