Provider Demographics
NPI:1225109960
Name:ISREAL, RONALD LEE (SOCIAL WORKER)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LEE
Last Name:ISREAL
Suffix:
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 BLACK OAK DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-0197
Mailing Address - Country:US
Mailing Address - Phone:817-874-4851
Mailing Address - Fax:817-556-0843
Practice Address - Street 1:4016 BLACK OAK DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76031-0197
Practice Address - Country:US
Practice Address - Phone:817-874-4851
Practice Address - Fax:817-556-0843
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19464104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker