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General NPI Number Information
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NPI Number | 1326524612
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Entity Type | Organization
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Legal Business Name | GREENHOUSE VASCULAR ACCESS CENTER, LLC
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 2222 GREENHOUSE RD STE 1500
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City | HOUSTON
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State | TX
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Zip | 77084-7855
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Country | US
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Telephone | 713-464-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 PALM HARBOR BLVD STE A
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City | PALM HARBOR
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State | FL
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Zip | 34683-1930
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Country | US
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Telephone | 727-474-0090
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Fax | 727-474-0055
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAHUL PRAKASH
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Credential | MD
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Telephone | 713-464-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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