Provider Demographics
NPI:1871906776
Name:NEIL M BEALKA JR MD PA
Entity type:Organization
Organization Name:NEIL M BEALKA JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BEALKA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:254-865-4267
Mailing Address - Street 1:2406 S. BUSINESS HWY 36
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528
Mailing Address - Country:US
Mailing Address - Phone:254-865-4267
Mailing Address - Fax:254-865-8293
Practice Address - Street 1:1400 FRANKLIN
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645
Practice Address - Country:US
Practice Address - Phone:254-582-0282
Practice Address - Fax:254-865-8293
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIL M BEALKA JR MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141555601Medicaid