Provider Demographics
NPI:1679831978
Name:NEAL, DONNIE A (LCDC)
Entity Type:Individual
Prefix:MRS
First Name:DONNIE
Middle Name:A
Last Name:NEAL
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79073-0278
Mailing Address - Country:US
Mailing Address - Phone:806-293-9722
Mailing Address - Fax:806-293-1822
Practice Address - Street 1:450 N IH 27
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-0055
Practice Address - Country:US
Practice Address - Phone:806-293-9722
Practice Address - Fax:806-293-1822
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9421305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service