Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | R0099 | TX |
NPI | 1114284445 |
---|---|
Provider Name | Dr. Anastasiia Neelagaru |
First Address | San Antonio, TX 78224-1366 |
Second Address | San Antonio, TX 78224-1366 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2012 |
Last Update Date | 30/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1114284445 | (05) | TX |