Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | BP10063406 | TX |
NPI | 1003313511 |
---|---|
Provider Name | Neetharika Thottempudi |
First Address | Galveston, TX 77555-0539 |
Second Address | Galveston, TX 77555-0539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2018 |
Last Update Date | 11/04/2018 |