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General NPI Number Information
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NPI Number | 1457399115
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Entity Type | Organization
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Legal Business Name | NORTH EAST HOSPITALIST MANAGEMENT, INC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 11803 SOUTH FWY STE 201
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City | BURLESON
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State | TX
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Zip | 76028-7029
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Country | US
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Telephone | 817-293-4800
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Fax | 817-293-4808
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Provider Business Mailing Address
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Address Line | 11803 SOUTH FWY STE 201
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City | BURLESON
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State | TX
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Zip | 76028-7029
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Country | US
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Telephone | 817-293-4800
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Fax | 817-293-4808
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. PRAKASH HEGDE
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Credential | M.D.
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Telephone | 817-293-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | L7415
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License Number State | TX
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