Provider Demographics
NPI:1194905877
Name:AGARWAL, NEAL KUMAR (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:KUMAR
Last Name:AGARWAL
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 1:7051 FM 1464 RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-9542
Mailing Address - Country:US
Mailing Address - Phone:128-176-6381
Mailing Address - Fax:
Practice Address - Street 1:7051 FM 1464 RD RM 317
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-9542
Practice Address - Country:US
Practice Address - Phone:128-176-6381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMMIS 00243903207P00000X
GA001815207R00000X
ALMD.29720207R00000X, 208M00000X
TXN4885207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-07853OtherBCBS
ALZ10657OtherVIVA HEALTH
AL120713Medicaid
AL511-07839OtherBCBS
AL119490587OtherTRICARE SOUTH
AL120709Medicaid
AL119490587OtherTRICARE SOUTH
AL102I113632Medicare PIN