Provider Demographics
NPI:1801868138
Name:NEAL, NEIL D (CRNA)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:D
Last Name:NEAL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 650252
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265
Mailing Address - Country:US
Mailing Address - Phone:888-863-3000
Mailing Address - Fax:817-334-0235
Practice Address - Street 1:2000 E. LAMAR
Practice Address - Street 2:400
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006
Practice Address - Country:US
Practice Address - Phone:888-863-3000
Practice Address - Fax:817-334-0235
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX508443367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088808304Medicaid