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NPI Code Detail

MEDICARE: ANURADHA PRABHU MD

MEDICARE: ANURADHA PRABHU 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
1207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianL2563TX
2207P00000XEmergency Medicine PhysicianL2563TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194773044
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANURADHA PRABHU MD
Provider Business Mailing Address
First Line : 2106 FAR GALLANT DR
Second Line :
City : AUSTIN
State : TX
Zip : 78746-1808
Country : US
Telephone Number : 512-328-0862
Fax Number :
Provider Business Practice Location Address
First Line : 901 W BEN WHITE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78704-6903
Country : US
Telephone Number : 512-447-2211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 05/14/2010

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Directions to “ ANURADHA PRABHU MD” Practice Location

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