Healthcare Provider Details

I. General information

NPI: 1982602512
Provider Name (Legal Business Name): NEELAM MATH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NEELAM MATH APRN

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 09/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5252 W UNIVERSITY DR
MCKINNEY TX
75071-7822
US

IV. Provider business mailing address

8517 GALLERY WAY
MCKINNEY TX
75072-8401
US

V. Phone/Fax

Practice location:
  • Phone: 214-738-0950
  • Fax:
Mailing address:
  • Phone: 214-738-0950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP112634
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: