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General NPI Number Information
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NPI Number | 1134366263
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Entity Type | Organization
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Legal Business Name | GARNEPUDI V PRASAD MD PA
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 110 E CROCKETT ST
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City | CLEVELAND
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State | TX
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Zip | 77327-4044
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Country | US
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Telephone | 281-592-1515
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Fax | 281-592-3807
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Provider Business Mailing Address
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Address Line | 110 E CROCKETT ST
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City | CLEVELAND
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State | TX
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Zip | 77327-4044
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Country | US
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Telephone | 281-592-1515
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Fax | 281-592-3807
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | IMELDA A THOMAS
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Credential |
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Telephone | 281-587-1141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G4194
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License Number State | TX
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