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General NPI Number Information
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NPI Number | 1144915133
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Entity Type | Individual
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Provider Name | DR. SHRUTHI PRABHAKAR
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Gender | Female
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Dates
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Enumeration Date | 04/06/2023
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 12160 W PARMER LN STE 110
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City | CEDAR PARK
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State | TX
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Zip | 78613-2490
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Country | US
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Telephone | 512-866-3184
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Fax |
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Provider Business Mailing Address
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Address Line | 3909 COLWICK CT
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City | PLANO
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State | TX
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Zip | 75023-1065
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Country | US
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Telephone | 972-333-0305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 41581
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License Number State | TX
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