Modur, Pradeep
Modur, Pradeep is an individual health care provider with primary practice located at 1600 W 38Th St Ste 200 , Austin TX 78731-6405. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Neurophysiology, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Modur, Pradeep can be contacted via phone (512) 324-3540.Contact Information
Primary practice address
1600 W 38Th St Ste 200
Austin TX 78731-6405
Phone: (512) 324-3540
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | M5841 | Texas |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | M5841 | Texas |
Profile Details
| NPI number | 1346248515 |
|---|---|
| LBN Legal business name | Modur, Pradeep |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Feb 5th, 2024 - about 2 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 | 1346248515 | NPPES |
| Kentucky | MEDICAID | 64017767 |
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