Organization
SAMUEL R NEELEY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL ROBERT NEELEY MD (PHYSICIAN)
(210) 525-1668
Entity
Organization
Contact information
Practice address
12446 WEST AVE, SUITE 200, SAN ANTONIO, TX 78216-2517
(210) 525-1668
(210) 525-1669
Mailing address
PO BOX 700447, SAN ANTONIO, TX 78270-0447
(210) 525-1668
(210) 525-1669
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
E8757
TX
261QM2500X
Medical Specialty Clinic/Center
E8757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015PZ
BLUE CROSS
TX
01
—
004203225
AETNA HEALTHCARE
TX
05
—
120344004
—
TX
Enumeration date
04/03/2007
Last updated
05/12/2015
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