Healthcare Provider Details

I. General information

NPI: 1952375024
Provider Name (Legal Business Name): PRASHANT JOSHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 ALAMEDA AVE
EL PASO TX
79905-2705
US

IV. Provider business mailing address

4800 ALBERTA AVE DEPARTMENT OF PEDIATRICS
EL PASO TX
79905-2709
US

V. Phone/Fax

Practice location:
  • Phone: 915-215-4879
  • Fax:
Mailing address:
  • Phone: 915-215-4879
  • Fax: 915-545-6975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberR0035
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: