Healthcare Provider Details

I. General information

NPI: 1790097988
Provider Name (Legal Business Name): NEELOFAR LALANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2010
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 N JOSEY LN STE 100
CARROLLTON TX
75007-1535
US

IV. Provider business mailing address

512 FOUR STONES BLVD
LEWISVILLE TX
75056-3893
US

V. Phone/Fax

Practice location:
  • Phone: 972-939-1362
  • Fax: 800-697-6409
Mailing address:
  • Phone: 405-414-0072
  • Fax: 800-697-6409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number257153
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number2018043066
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number3606
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberU2546
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: