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NPI Code Detail

MEDICARE: PRABHASH KAKARLA

MEDICARE: PRABHASH KAKARLA
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
1207R00000XInternal Medicine Physician314513NY
2390200000XStudent in an Organized Health Care Education/Training Program
3207R00000XInternal Medicine PhysicianU1046TX

General Provider Information

NPI Number : 1689140634
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRABHASH KAKARLA
Provider Business Mailing Address
First Line : 2302 LONE STAR RD STE 200
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-8751
Country : US
Telephone Number : 682-341-7200
Fax Number : 682-341-7201
Provider Business Practice Location Address
First Line : 2302 LONE STAR RD STE 200
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-8751
Country : US
Telephone Number : 682-341-7200
Fax Number : 682-341-7201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2018
Last Update Date : 01/17/2023

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Directions to “ PRABHASH KAKARLA ” Practice Location

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