Provider Demographics
NPI:1780293795
Name:MCNEAL, LATASHA
Entity type:Individual
Prefix:
First Name:LATASHA
Middle Name:
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15130 MARSH LN # 1019
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-8047
Mailing Address - Country:US
Mailing Address - Phone:214-293-1470
Mailing Address - Fax:
Practice Address - Street 1:15130 MARSH LN
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-8047
Practice Address - Country:US
Practice Address - Phone:214-293-1470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-26
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health