Provider Demographics
NPI:1972578680
Name:NEILL, CHRISTOPHER LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LYNN
Last Name:NEILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 FM 2854
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-2740
Mailing Address - Country:US
Mailing Address - Phone:936-539-4004
Mailing Address - Fax:936-539-3635
Practice Address - Street 1:704 FM 2854
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-2740
Practice Address - Country:US
Practice Address - Phone:936-539-4004
Practice Address - Fax:936-539-3635
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5790207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1228082-04Medicaid
TX122808205Medicaid
TX00J25GMedicare ID - Type Unspecified
TXE09342Medicare UPIN
TX122808205Medicaid