Healthcare Provider Details

I. General information

NPI: 1780874578
Provider Name (Legal Business Name): NEHA RESHAMWALA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2217 PARK BEND DR
AUSTIN TX
78758-5072
US

IV. Provider business mailing address

2217 PARK BEND DR STE 300
AUSTIN TX
78758-5674
US

V. Phone/Fax

Practice location:
  • Phone: 512-382-1933
  • Fax: 512-777-4949
Mailing address:
  • Phone: 512-382-1933
  • Fax: 844-880-6124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberP0478
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: