Provider Demographics
NPI:1053352294
Name:SPEARS, NEAL MOREAU (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:MOREAU
Last Name:SPEARS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 HIGHWAY 6 S
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4428
Mailing Address - Country:US
Mailing Address - Phone:979-690-4480
Mailing Address - Fax:979-690-4481
Practice Address - Street 1:4401 HIGHWAY 6 S
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-4428
Practice Address - Country:US
Practice Address - Phone:979-690-4480
Practice Address - Fax:979-690-4481
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4729208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151020811Medicaid
TX151020808Medicaid
TX8CV053OtherBCBS
TX151020807Medicaid
TX8CV053OtherBCBS