Provider Demographics
NPI:1821094798
Name:NEAL, GREGORY S (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:S
Last Name:NEAL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4499 MEDICAL DR
Mailing Address - Street 2:STE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3717
Mailing Address - Country:US
Mailing Address - Phone:210-692-0577
Mailing Address - Fax:210-692-1210
Practice Address - Street 1:4499 MEDICAL DR
Practice Address - Street 2:STE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3717
Practice Address - Country:US
Practice Address - Phone:210-692-0577
Practice Address - Fax:210-692-1210
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2010-07-28
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Provider Licenses
StateLicense IDTaxonomies
TXH6463207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74-2011840OtherTAX IDENTIFICATION NUMBER
TXH-6463OtherPHYSICIAN LICENSE PERMIT
TXG91409Medicare UPIN