Provider Demographics
NPI:1679050272
Name:NEAL, CATHERINE HEATON (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:HEATON
Last Name:NEAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 PENINSULA POINT TER
Mailing Address - Street 2:
Mailing Address - City:MABANK
Mailing Address - State:TX
Mailing Address - Zip Code:75156-7592
Mailing Address - Country:US
Mailing Address - Phone:903-880-5941
Mailing Address - Fax:
Practice Address - Street 1:147 PENINSULA POINT TER
Practice Address - Street 2:
Practice Address - City:MABANK
Practice Address - State:TX
Practice Address - Zip Code:75156-7592
Practice Address - Country:US
Practice Address - Phone:903-880-5941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1012193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist