MEDICARE: ANDREW MICHAEL MCNEELY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA08754	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	335734YLAL	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801225032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW MICHAEL MCNEELY PA

Provider Business Mailing Address
First Line	:	8195 CUSTER RD STE 110
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-3195
Country	:	US
Telephone Number	:	214-666-6259
Fax Number	:	855-618-2235

Provider Business Practice Location Address
First Line	:	3537 S INTERSTATE 35
Second Line	:	SUITE 320
City	:	DENTON
State	:	TX
Zip	:	76210-6870
Country	:	US
Telephone Number	:	214-666-6259
Fax Number	:	855-618-2235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2013
Last Update Date	:	10/10/2024

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