Provider Demographics
NPI:1639359458
Name:SURESH B NEELAGARU MD PA
Entity Type:Organization
Organization Name:SURESH B NEELAGARU MD PA
Other - Org Name:SAN ANTONIO CARDIOVASCULAR AND RHYTHM CENTER ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:NEELAGARU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:210-718-0850
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:210-718-0850
Mailing Address - Fax:210-519-3107
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:2007-11-08
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-4593207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DB5006OtherMEDICARE B - RAIL ROAD
0092LEOtherBCBS-TX
TX168034001Medicaid
0092LEOtherBCBS-TX