Provider Demographics
NPI:1134847726
Name:GADDAM, NEELIMA (MD)
Entity type:Individual
Prefix:
First Name:NEELIMA
Middle Name:
Last Name:GADDAM
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 1:12602 TOEPPERWEIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3204
Mailing Address - Country:US
Mailing Address - Phone:210-646-1994
Mailing Address - Fax:877-212-6201
Practice Address - Street 1:12602 TOEPPERWEIN RD STE 100
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3204
Practice Address - Country:US
Practice Address - Phone:210-646-1994
Practice Address - Fax:877-212-6201
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXW0162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program