Healthcare Provider Details
I. General information
NPI: 1831761857
Provider Name (Legal Business Name): PRISHIV ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/12/2021
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2120 PRAIRIE DR STE 102
PROSPER TX
75078-3818
US
IV. Provider business mailing address
2120 PRAIRIE DR STE 102
PROSPER TX
75078-3818
US
V. Phone/Fax
- Phone: 972-544-9455
- Fax: 972-544-9465
- Phone: 972-544-9455
- Fax: 972-544-9465
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PRAGADEESWARI
DHANASEKARAN
Title or Position: DIRECTOR
Credential: MD
Phone: 972-544-9455