Provider Demographics
NPI:1992090435
Name:MCNEAL, STEFANIE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:
Other - Last Name:SIMONSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5445 PRESTON OAKS RD APT 212
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-2419
Mailing Address - Country:US
Mailing Address - Phone:972-289-0691
Mailing Address - Fax:972-289-0692
Practice Address - Street 1:1313 N BELT LINE RD STE 102
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1784
Practice Address - Country:US
Practice Address - Phone:972-289-0691
Practice Address - Fax:972-289-0692
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1206368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist