Provider Demographics
NPI:1174661565
Name:PRASHAD, JOANNE B (MD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:B
Last Name:PRASHAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:BEDNARZ-PRASHAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 20098
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77225-0098
Mailing Address - Country:US
Mailing Address - Phone:713-850-1190
Mailing Address - Fax:713-850-1327
Practice Address - Street 1:6411 FANNIN STREET
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:832-778-0601
Practice Address - Fax:832-778-0604
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4864207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155572401Medicaid
TX155572401Medicaid
H69805Medicare UPIN