Peddu, Prasad K
Peddu, Prasad K is an sole proprietor health care provider with primary practice located at 515 Gaslight Blvd , Lufkin TX 75904-3127. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Peddu, Prasad K can be contacted via phone (936) 634-3995.Contact Information
Primary practice address
515 Gaslight Blvd
Lufkin TX 75904-3127
Phone: (936) 634-3995
Fax: (936) 634-4022
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | J9263 | Texas |
Profile Details
| NPI number | 1487656468 |
|---|---|
| LBN Legal business name | Peddu, Prasad K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Aug 27th, 2015 - about 11 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 | 1487656468 | NPPES |
| Texas | Other | 110114826 | MEDICARE RAILROAD ID |
| Texas | Other | 261887122 | MEDICARE RAILROAD ID |
| Texas | MEDICAID | 038251701 | MEDICARE RAILROAD ID |
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