Provider Demographics
NPI:1932609898
Name:NEAL, SABRINA KAY (LVN)
Entity type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:KAY
Last Name:NEAL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10662 CIRCLE PT
Mailing Address - Street 2:
Mailing Address - City:FRANKSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75763-4414
Mailing Address - Country:US
Mailing Address - Phone:903-876-4312
Mailing Address - Fax:
Practice Address - Street 1:755 S BECKHAM AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1903
Practice Address - Country:US
Practice Address - Phone:903-534-4684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-17
Last Update Date:2018-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX309256164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty