MEDICARE: DR. DANIELLE ELIZABETH NEAL D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	0102203994	VA

General Provider Information

NPI Number	:	1154760353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE ELIZABETH NEAL D.O.

Provider Business Mailing Address
First Line	:	3551 ROGER BROOKE DR
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	210-292-5350
Fax Number	:	210-292-5350

Provider Business Practice Location Address
First Line	:	3551 ROGER BROOKE DR
Second Line	:	JBSA
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234
Country	:	US
Telephone Number	:	210-292-5350
Fax Number	:	210-292-5350

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	05/05/2026

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