Provider Demographics
NPI:1114275062
Name:SHRIRANG S. NEURGAONKAR MD,PA
Entity type:Organization
Organization Name:SHRIRANG S. NEURGAONKAR MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHRIRANG
Authorized Official - Middle Name:SHRIDHAR
Authorized Official - Last Name:NEURGAONKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-874-3776
Mailing Address - Street 1:3611 MORRISS RD
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2648
Mailing Address - Country:US
Mailing Address - Phone:972-874-3776
Mailing Address - Fax:972-691-1444
Practice Address - Street 1:3611 MORRISS RD
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2648
Practice Address - Country:US
Practice Address - Phone:972-874-3776
Practice Address - Fax:972-691-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7112207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty