Provider Demographics
NPI:1174740351
Name:NEAL, VIRGINIA (PHD, NP)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:PHD, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 PRUDENTIAL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-4109
Mailing Address - Country:US
Mailing Address - Phone:214-522-4640
Mailing Address - Fax:214-522-4650
Practice Address - Street 1:1475 PRUDENTIAL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-4109
Practice Address - Country:US
Practice Address - Phone:972-248-2299
Practice Address - Fax:972-248-2012
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24933103T00000X
TX507763363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist