Provider Demographics
NPI:1477591824
Name:KURIAN, NEESHA DEVARAJ (MD)
Entity type:Individual
Prefix:
First Name:NEESHA
Middle Name:DEVARAJ
Last Name:KURIAN
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 1:100 W DEAN KEETON ST
Mailing Address - Street 2:CAMPUS MAIL A3900 (UHS) OR CAMPUS MAIL A3500 (CMHC)
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 W DEAN KEETON ST
Practice Address - Street 2:CAMPUS MAIL A3900 (UHS) OR CAMPUS MAIL A3500 (CMHC)
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712
Practice Address - Country:US
Practice Address - Phone:512-471-4955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1859207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177252701Medicaid
TX8D9669Medicare ID - Type Unspecified
TX177252701Medicaid