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General NPI Number Information
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NPI Number | 1114479334
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Entity Type | Organization
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Legal Business Name | SOUTHWEST NEUROCARDIAC CENTER PLLC
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Dates
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Enumeration Date | 11/04/2016
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 7430 BARLITE BLVD STE 108
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City | SAN ANTONIO
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State | TX
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Zip | 78224-1366
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Country | US
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Telephone | 210-718-0850
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 90688
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City | SAN ANTONIO
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State | TX
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Zip | 78209-9089
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SURESH B NEELAGARU
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Credential | M.D.
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Telephone | 806-236-4198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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