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NPI Code Detail

MEDICARE: KRISTI NEALY P.A.

MEDICARE: KRISTI NEALY P.A.
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
1363AM0700XMedical Physician AssistantPA03940TX

General Provider Information

NPI Number : 1386642734
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTI NEALY P.A.
Provider Business Mailing Address
First Line : 1107 E MARSHALL AVE
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5602
Country : US
Telephone Number : 903-758-2610
Fax Number : 903-758-7081
Provider Business Practice Location Address
First Line : 705 E MARSHALL AVE STE 3000
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5661
Country : US
Telephone Number : 903-758-2610
Fax Number : 903-758-7081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 04/26/2024

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Directions to “ KRISTI NEALY P.A.” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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