Provider Demographics
NPI:1114479334
Name:SOUTHWEST NEUROCARDIAC CENTER PLLC
Entity Type:Organization
Organization Name:SOUTHWEST NEUROCARDIAC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:NEELAGARU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-236-4198
Mailing Address - Street 1:PO BOX 90688
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-9089
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7430 BARLITE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1366
Practice Address - Country:US
Practice Address - Phone:210-718-0850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty