Provider Demographics
NPI:1962180695
Name:NEAL, DEMERIA
Entity type:Individual
Prefix:
First Name:DEMERIA
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 TRAVIS ST STE 2101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-5730
Mailing Address - Country:US
Mailing Address - Phone:850-284-9368
Mailing Address - Fax:
Practice Address - Street 1:801 TRAVIS ST STE 2101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-5730
Practice Address - Country:US
Practice Address - Phone:850-284-9368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier