Provider Demographics
NPI:1760949937
Name:ZIEDAN, NEAL (RN)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:
Last Name:ZIEDAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 COUNTY ROAD 4121
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-5191
Mailing Address - Country:US
Mailing Address - Phone:903-707-9576
Mailing Address - Fax:
Practice Address - Street 1:520 COUNTY ROAD 4121
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-5191
Practice Address - Country:US
Practice Address - Phone:903-707-9576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX962532163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse