Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | L4593 | TX |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | L4593 | TX |
NPI | 1205813920 |
---|---|
Provider Name | Suresh B Neelagaru |
First Address | San Antonio, TX 78209-5950 |
Second Address | San Antonio, TX 78224-1366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 14/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H37144 | (02) |