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General NPI Number Information
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NPI Number | 1407176159
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Entity Type | Individual
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Provider Name | PRASANNA K. MARPU MD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 921 NE 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5007
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Country | US
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Telephone | 405-456-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 12221 N MOPAC EXPY
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City | AUSTIN
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State | TX
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Zip | 78758-2401
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Country | US
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Telephone | 512-901-4937
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | T4424
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01069153A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | T4424
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License Number State | TX
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