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Individual

PHYLLIS F. MCNIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPO

Contact information

Practice address
800 E CALIFORNIA ST, SUITE 1, GAINESVILLE, TX 76240-4281
(940) 668-1118
(940) 668-1123
Mailing address
800 E CALIFORNIA ST, SUITE 1, GAINESVILLE, TX 76240-4281
(940) 668-1118
(940) 668-1123

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
121
TX
224P00000X
Prosthetist
Primary
121
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
121
TEXAS BOARD OF ORTHOTICS/PROSTHETICS
TX
Enumeration date
05/26/2012
Last updated
05/26/2012
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