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Susan E Mcneil

Family Medicine

Allopathic & Osteopathic Physicians

1500 S Main St, Fort Worth, TX 76104-4917

PECOS Enrollment

This provider is enrolled in PECOS as SUSAN MCNEIL.

Based on the most recent information from CMS, provider Susan E Mcneil is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1124048327
Provider Type
Individual
Full Name
Mcneil, Susan E
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
7/20/2006
Last Updated
8/19/2013

Contact Information

Practice Location

1500 S Main St, Fort Worth, TX 76104-4917

(817) 921-3431

Unlisted Fax

Mailing Location

1500 S Main St, Fort Worth, TX 76104-4917

(817) 921-3431

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License K3335 Texas

Provider Identifiers

ID	Description	Issuer
ID 104615304	Description Medicaid	Issuer Unlisted Texas

Susan E Mcneil

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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