Provider Demographics
NPI:1366117327
Name:PINGLE, NEELAM RAJENDRA (NP-C)
Entity type:Individual
Prefix:
First Name:NEELAM
Middle Name:RAJENDRA
Last Name:PINGLE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14328 NEW BRAUNFELS DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5384
Mailing Address - Country:US
Mailing Address - Phone:248-808-4380
Mailing Address - Fax:
Practice Address - Street 1:940 W STACY RD STE 110
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5215
Practice Address - Country:US
Practice Address - Phone:214-453-0568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1064484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty