Provider Demographics
NPI:1154531200
Name:MCNEIL, KATHRYN ELAINE (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ELAINE
Last Name:MCNEIL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ELAINE MCSPADDEN
Other - Last Name:MCNEIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1801 HALSTEAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1811
Mailing Address - Country:US
Mailing Address - Phone:806-352-2742
Mailing Address - Fax:806-352-2744
Practice Address - Street 1:7105 SW 34TH AVE STE J
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-2904
Practice Address - Country:US
Practice Address - Phone:806-352-2742
Practice Address - Fax:806-352-2744
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP24942084P0800X
AZ405412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200578660 AMedicaid
TX307455103Medicaid
NM91706599Medicaid
OK200578660 AMedicaid
NM91706599Medicaid