Provider Demographics
NPI:1851020127
Name:KORLA, NEHA
Entity Type:Individual
Prefix:DR
First Name:NEHA
Middle Name:
Last Name:KORLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 W SLAUGHTER LN STE 190
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5997
Mailing Address - Country:US
Mailing Address - Phone:512-593-4465
Mailing Address - Fax:
Practice Address - Street 1:2110 W SLAUGHTER LN STE 190
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5997
Practice Address - Country:US
Practice Address - Phone:512-760-3346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX385831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice