Provider Demographics
NPI:1144066853
Name:NEVIL, JANET D (LO, BOCO, CPED)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:D
Last Name:NEVIL
Suffix:
Gender:F
Credentials:LO, BOCO, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3902 GASTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1511
Mailing Address - Country:US
Mailing Address - Phone:214-824-4507
Mailing Address - Fax:214-824-7553
Practice Address - Street 1:3902 GASTON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1511
Practice Address - Country:US
Practice Address - Phone:214-824-4507
Practice Address - Fax:214-824-7553
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX542222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist