Provider Demographics
NPI:1134923840
Name:NEAL, LAQUINTA
Entity type:Individual
Prefix:
First Name:LAQUINTA
Middle Name:
Last Name:NEAL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 GRANITE PARK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2177
Mailing Address - Country:US
Mailing Address - Phone:501-993-0765
Mailing Address - Fax:
Practice Address - Street 1:2210 GRANITE PARK LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2177
Practice Address - Country:US
Practice Address - Phone:501-993-0765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No171M00000XOther Service ProvidersCase Manager/Care Coordinator