Provider Demographics
NPI:1326040601
Name:NEAL, MARY T (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:T
Last Name:NEAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7900 FANNIN ST
Mailing Address - Street 2:SUITE 3053
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2934
Mailing Address - Country:US
Mailing Address - Phone:713-512-7000
Mailing Address - Fax:713-512-7561
Practice Address - Street 1:7900 FANNIN ST
Practice Address - Street 2:SUITE 4000
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2934
Practice Address - Country:US
Practice Address - Phone:713-512-7000
Practice Address - Fax:713-512-7561
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG1128207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83056GOtherBLUE CROSS & BLUE SHIELD
TX84285JMedicare PIN
TX84285JMedicare ID - Type UnspecifiedHARRIS COUNTY
TX84357JMedicare ID - Type UnspecifiedFT. BEND COUNTY
TX84303JMedicare ID - Type UnspecifiedBRAZORIA COUNTY
TX84303JMedicare PIN
TX84357JMedicare PIN
TX83056GOtherBLUE CROSS & BLUE SHIELD