Devabhaktuni, Prasad
Devabhaktuni, Prasad is an individual health care provider with primary practice located at 3560 Delaware St Ste 209 , Beaumont TX 77706-3059. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Devabhaktuni, Prasad can be contacted via phone (409) 899-3682.Contact Information
Primary practice address
3560 Delaware St Ste 209
Beaumont TX 77706-3059
Phone: (409) 899-3682
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 036060837 | Illinois |
Profile Details
| NPI number | 1871527028 |
|---|---|
| LBN Legal business name | Devabhaktuni, Prasad |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Jun 20th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871527028 | NPPES |
| Illinois | MEDICAID | 0360608371 | |
| Illinois | MEDICAID | 200462402 | |
| Illinois | MEDICAID | 200108170 |
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