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General NPI Number Information
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NPI Number | 1558617076
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Entity Type | Organization
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Legal Business Name | PRASANNAK N KUMAR MD F R C S PA
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 08/08/2012
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Provider Practice Location Address
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Address Line | 2712 HURSTVIEW DR
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City | HURST
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State | TX
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Zip | 76054-2402
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Country | US
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Telephone | 817-589-2512
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Fax | 817-284-7021
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Provider Business Mailing Address
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Address Line | 3813 DIAMOND LOCH W
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-8729
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Country | US
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Telephone | 817-589-2517
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PRASANNA KUMAR
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Credential | MD
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Telephone | 817-589-2517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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