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
Fax: (936) 634-4022
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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