Provider Demographics
NPI:1538555982
Name:NEELEY, OM JAMES (MD)
Entity type:Individual
Prefix:
First Name:OM
Middle Name:JAMES
Last Name:NEELEY
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 1:1139 E SONTERRA BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4348
Mailing Address - Country:US
Mailing Address - Phone:210-477-1956
Mailing Address - Fax:210-477-5774
Practice Address - Street 1:1139 E SONTERRA BLVD STE 301
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4348
Practice Address - Country:US
Practice Address - Phone:210-477-1956
Practice Address - Fax:210-477-5774
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT4439207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program