Provider Demographics
NPI:1083951529
Name:WESTOVER HILLS LUNG CENTER
Entity Type:Organization
Organization Name:WESTOVER HILLS LUNG CENTER
Other - Org Name:SASIKANTH NALLAGATLA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SASIKANTH
Authorized Official - Middle Name:
Authorized Official - Last Name:NALLAGATLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-370-2333
Mailing Address - Street 1:10004 WURZBACH RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2214
Mailing Address - Country:US
Mailing Address - Phone:210-370-2333
Mailing Address - Fax:
Practice Address - Street 1:3303 ROGERS ROAD
Practice Address - Street 2:ROGERS ROAD MEDICAL PLAZA SUITE 250
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:210-417-4142
Practice Address - Fax:210-702-3372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5273207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX345733501Medicaid
TX345733501Medicaid