Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | L6145 | TX |
NPI | 1013947043 |
---|---|
Provider Name | Latha Prasannan |
First Address | Dallas, TX 75284-1314 |
Second Address | Temple, TX 76502-1814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 27/01/2022 |