Healthcare Provider Details

I. General information

NPI: 1285259564
Provider Name (Legal Business Name): SNEHA GEORGE TERESSA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N KENTUCKY AVE
WEST PLAINS MO
65775-2029
US

IV. Provider business mailing address

1100 N KENTUCKY AVE
WEST PLAINS MO
65775-2029
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-1216
  • Fax: 718-960-1370
Mailing address:
  • Phone: 718-960-1216
  • Fax: 718-960-1370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2026010028
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: