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NPI Code Detail

MEDICARE: MARY T NEAL M.D.

MEDICARE:   MARY T NEAL  M.D.
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
1207VG0400XGynecology PhysicianG1128TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
183056GOTHERTXBLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number : 1326040601
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY T NEAL M.D.
Provider Business Mailing Address
First Line : 7900 FANNIN ST
Second Line : SUITE 3053
City : HOUSTON
State : TX
Zip : 77054-2934
Country : US
Telephone Number : 713-512-7000
Fax Number : 713-512-7561
Provider Business Practice Location Address
First Line : 7900 FANNIN ST
Second Line : SUITE 4000
City : HOUSTON
State : TX
Zip : 77054-2934
Country : US
Telephone Number : 713-512-7000
Fax Number : 713-512-7561
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 01/22/2009

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Directions to “ MARY T NEAL M.D.” Practice Location

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