Individual provider Active NPI

Thomas Manning Neale Jr., RPH

  • Pharmacist
  • Southlake, TX
National Provider Identifier
1417619677
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
29336 Issued in TX
Practice address
721 E Southlake Blvd Ste 180
Southlake, TX 76092-6587
Phone
(817) 410-1000
Fax
(817) 410-1001
NPI assigned
Oct 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29336 TX Primary

Addresses

Primary practice location

721 E Southlake Blvd Ste 180
Southlake, TX 76092-6587

Mailing address

3020 Corporate CT Ste 300
Flower Mound, TX 75028-5617
Phone (972) 539-3624

Other practice location 1

420 S Denton Tap Rd Ste 110
Coppell, TX 75019-3266
Phone (972) 462-9400

Other identifiers 1

IdentifierTypeStateIssuer
29336OtherTXPHARMACIST LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
29336TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrimed Clinics LLC Current Accepting new patients
Pharmacy Plus, Inc. PastSince Jan 22, 2023 Accepting new patients
Pharmacy Plus Inc PastSince Oct 10, 2021 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1417619677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CORPORATE CT STE 300",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750285617",
            "telephone_number": "972-539-3624",
            "fax_number": "972-539-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 E SOUTHLAKE BLVD STE 180",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926587",
            "telephone_number": "817-410-1000",
            "fax_number": "817-410-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 S Denton Tap Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Coppell",
            "state": "TX",
            "postal_code": "750193266",
            "country_code": "US",
            "telephone_number": "972-462-9400",
            "fax_number": "972-462-9600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEALE",
        "first_name": "THOMAS",
        "middle_name": "MANNING",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "29336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "29336",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.