Provider Demographics
NPI:1407887425
Name:NAYAK, NEETA GOPINATH (MD)
Entity Type:Individual
Prefix:
First Name:NEETA
Middle Name:GOPINATH
Last Name:NAYAK
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 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 651
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-820-9115
Mailing Address - Fax:214-820-9135
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:SUITE 651
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-820-9115
Practice Address - Fax:214-820-9135
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8375207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046388704Medicaid
TX046388705Medicaid
TX046388707Medicaid
TX046388701Medicaid
TX046388711Medicaid
TX046388706Medicaid
TX046388702Medicaid
TX046388703Medicaid
TXG93675Medicare UPIN
TX046388703Medicaid
TX046388704Medicaid
TX046388702Medicaid
TX88170NMedicare ID - Type Unspecified
TX8J7007Medicare PIN
TX046388701Medicaid
TX8L9533Medicare PIN
TX8L9259Medicare PIN
TX8L9258Medicare PIN