JACK M. NEAGLE JR., DDS, PC; NPI #1710126768

Contact Information

JACK M. NEAGLE JR., DDS, PC

1805 W WHITE OAK TER
SUITE C
CONROE, TX 77304-3590

Phone: 936-539-2980
Fax: 936-539-2969
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for JACK M. NEAGLE JR., DDS, PC

NPI # 1710126768

LBN Legal business name JACK M. NEAGLE JR., DDS, PC

Authorized official JACK NEAGLE - (REGISTERED AGENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/16/2009

Last updated 04/21/2009 - About 17 years ago

Identifiers

License #

22205

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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