Organization
NEUROHELATH CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. UMA PULIPAKA MD (PRESIDENT)
(903) 757-7056
Entity
Organization
Contact information
Practice address
713 N 4TH ST, SUITE #2, LONGVIEW, TX 75601-5412
(903) 757-7056
(903) 757-7260
Mailing address
PO BOX 1432, LONGVIEW, TX 75606-1432
(903) 757-7056
(903) 757-7260
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
L4660
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152867101
—
TX
Enumeration date
04/20/2007
Last updated
11/08/2011
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