Provider Demographics
NPI:1316180060
Name:UPPUTURI, NEELIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:NEELIMA
Middle Name:
Last Name:UPPUTURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W COLLEGE ST
Mailing Address - Street 2:SUITE 480
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3580
Mailing Address - Country:US
Mailing Address - Phone:817-305-5072
Mailing Address - Fax:817-305-5073
Practice Address - Street 1:1600 W COLLEGE ST
Practice Address - Street 2:SUITE 480
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3580
Practice Address - Country:US
Practice Address - Phone:817-305-5072
Practice Address - Fax:817-305-5073
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6737207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CL726OtherBCBSTX
TX217058101Medicaid
TX217058101Medicaid
TXP00910174Medicare PIN