Healthcare Provider Details

I. General information

NPI: 1922263375
Provider Name (Legal Business Name): PRASHANTH PEDDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7474 N GRAND PKWY W C1 400
SPRING TX
77379-1570
US

IV. Provider business mailing address

930 FROSTWOOD DR STE 2.200
HOUSTON TX
77024-2450
US

V. Phone/Fax

Practice location:
  • Phone: 832-717-7825
  • Fax: 832-717-7826
Mailing address:
  • Phone: 713-338-5502
  • Fax: 713-338-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberP1384
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP1384
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301091957
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: