MEDICARE: DR. JOSEPH R NEELEY JR. DDS

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	1223G0001X	General Practice Dentistry	10152	TX

General Provider Information

NPI Number	:	1841416344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH R NEELEY JR. DDS

Provider Business Mailing Address
First Line	:	901 S MO PAC EXPY BLDG 1 STE 470
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-5776
Country	:	US
Telephone Number	:	512-327-6947
Fax Number	:	512-329-6472

Provider Business Practice Location Address
First Line	:	901 S MO PAC EXPY BLDG 1 STE 470
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-5776
Country	:	US
Telephone Number	:	512-327-6947
Fax Number	:	512-329-6472

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	07/08/2007

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