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General NPI Number Information
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NPI Number | 1821322595
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Entity Type | Organization
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Legal Business Name | PRASANNA K.N.KUMAR M.D. F.R.C.S. P.A.
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 09/28/2009
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Provider Practice Location Address
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Address Line | 3813 DIAMOND LOCH W
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City | FORT WORTH
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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 | 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 | FORT WORTH
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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 | 817-284-7021
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PRASANNA KUMAR
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Credential | M.D.
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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 | F6274
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | F6274
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License Number State | TX
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