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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871527028 NPPES
Illinois MEDICAID 0360608371
Illinois MEDICAID 200462402
Illinois MEDICAID 200108170

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