MEDICARE: DR. PRAKASH HEGDE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	L7415	TX
2	207R00000X	Internal Medicine Physician	L7415	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00338137	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8P2640	OTHER	TX	TEXAS BLUE CROSS
4	5M088	OTHER	AR	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1053382754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRAKASH HEGDE MD

Provider Business Mailing Address
First Line	:	11803 SOUTH FWY STE 201
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-7029
Country	:	US
Telephone Number	:	817-293-4800
Fax Number	:	817-293-4808

Provider Business Practice Location Address
First Line	:	11803 SOUTH FWY STE 201
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-7029
Country	:	US
Telephone Number	:	817-293-4800
Fax Number	:	817-293-4808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	04/21/2026

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Directions to “ DR. PRAKASH HEGDE MD” Practice Location

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