Provider Demographics
NPI:1134494040
Name:THOMAS, NEAL
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6045 EMMA BAY CT UNIT 102
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3779
Mailing Address - Country:US
Mailing Address - Phone:702-468-6502
Mailing Address - Fax:702-823-5905
Practice Address - Street 1:3624 RUSSIAN OLIVE ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7643
Practice Address - Country:US
Practice Address - Phone:702-468-6502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor