Individual
HAYDEN BOYD MCNEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
17376 NORTHWEST FWY, JERSEY VILLAGE, TX 77040-1114
(832) 919-8484
(832) 919-8446
Mailing address
1802 28TH AVE N, TEXAS CITY, TX 77590-4134
(409) 750-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA12705
TX
363A00000X
Physician Assistant
TEMPORARY
TX
363AM0700X
Medical Physician Assistant
Primary
PA12705
TX
390200000X
Student in an Organized Health Care Education/Training Program
TEMPORARY
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1161319
NCCPA ID
TX
01
—
PA12705
LICENSE NUMBER
TX
Enumeration date
03/05/2019
Last updated
08/03/2022
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