MEDICARE: DONOVAN SHAWNDRICK NEAL

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	106S00000X	Behavior Technician	940242589	AR

General Provider Information

NPI Number	:	1588507412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONOVAN SHAWNDRICK NEAL

Provider Business Mailing Address
First Line	:	3423 FOREST LN APT 228
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-7751
Country	:	US
Telephone Number	:	903-556-9398
Fax Number	:

Provider Business Practice Location Address
First Line	:	3423 FOREST LN APT 228
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-7751
Country	:	US
Telephone Number	:	903-556-9398
Fax Number	:

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

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “ DONOVAN SHAWNDRICK NEAL ” Practice Location

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