Provider Demographics
NPI:1205889052
Name:NEELAKANTAN, ARVIND (MD)
Entity type:Individual
Prefix:
First Name:ARVIND
Middle Name:
Last Name:NEELAKANTAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 N CENTRAL EXPY STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5025
Mailing Address - Country:US
Mailing Address - Phone:214-739-3900
Mailing Address - Fax:214-739-3901
Practice Address - Street 1:9600 N CENTRAL EXPY STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5025
Practice Address - Country:US
Practice Address - Phone:214-739-3900
Practice Address - Fax:214-739-3901
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5851207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185886202Medicaid
TX8W9931OtherBCBS
TX185886202Medicaid
TX8J6651Medicare PIN
TXI70870Medicare UPIN