Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | L4654 | TX |
NPI | 1023089703 |
---|---|
Provider Name | Ananth K Prasad |
First Address | San Antonio, TX 78229-3824 |
Second Address | San Antonio, TX 78229-3824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
150663603 | (05) | TX |
8CM515 | BCBS (01) | TX |
G38197 | (02) | TX |
P00898266 | RAILROAD MEDICARE (01) | TX |
TXB112503 | MEDICARE (01) | TX |