Manjunath, Prema

Manjunath, Prema is an individual health care provider with primary practice located at 855 Montgomery St , Fort Worth TX 76107-2553. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Forensic Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Manjunath, Prema can be contacted via phone (817) 927-3638.

Contact Information

Primary practice address
855 Montgomery St Fort Worth TX 76107-2553
Phone: (817) 927-3638
Fax: (817) 923-8769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Forensic Psychiatry 2084F0202X H3699 Texas
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X H3699 Texas
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X H3699 Texas

Profile Details

NPI number 1013962745
LBN Legal business name Manjunath, Prema
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Aug 9th, 2016 - about 8 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 1013962745 NPPES
Texas Other 83702S BCBS
Texas MEDICAID 135013410 BCBS
Texas Other P00340949 BCBS

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