Provider Demographics
NPI:1760686349
Name:NEELA, SANGEETA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANGEETA
Middle Name:
Last Name:NEELA
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 1:1845 PRECINCT LINE RD STE 209
Mailing Address - Street 2:APT# 207
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3109
Mailing Address - Country:US
Mailing Address - Phone:817-336-4638
Mailing Address - Fax:817-336-7637
Practice Address - Street 1:1845 PRECINCT LINE RD STE 209
Practice Address - Street 2:APT# 207
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3109
Practice Address - Country:US
Practice Address - Phone:817-336-4638
Practice Address - Fax:817-336-7637
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN59052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX216978103Medicaid
TX216978103Medicaid
TXTXB136730Medicare PIN