Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | M8260 | TX |
NPI | 1316073067 |
---|---|
Provider Name | Rajani Prabhakaran |
First Address | Austin, TX 78723-3078 |
Second Address | Austin, TX 78723-3078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 02/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
192244501 | (05) | TX |