Provider Demographics
NPI:1760428619
Name:BHATIA, NEERA (MD)
Entity Type:Individual
Prefix:
First Name:NEERA
Middle Name:
Last Name:BHATIA
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 1:1303 MCCULLOUGH AVE
Mailing Address - Street 2:#237
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5609
Mailing Address - Country:US
Mailing Address - Phone:210-222-2694
Mailing Address - Fax:210-222-2565
Practice Address - Street 1:1303 MCCULLOUGH AVE
Practice Address - Street 2:#237
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5609
Practice Address - Country:US
Practice Address - Phone:210-222-2694
Practice Address - Fax:210-222-2565
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5319207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098140901Medicaid
C13445Medicare UPIN
TX098140901Medicaid