Provider Demographics
NPI:1326244849
Name:RAHUL PRAKASH, M.D., P.A.
Entity Type:Organization
Organization Name:RAHUL PRAKASH, M.D., P.A.
Other - Org Name:RENAL CLINIC OF HOUSTON
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-464-9100
Mailing Address - Street 1:411 PARK GROVE LN SUITE 310
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450
Mailing Address - Country:US
Mailing Address - Phone:713-464-9100
Mailing Address - Fax:713-468-6183
Practice Address - Street 1:411 PARK GROVE LN SUITE 310
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7745
Practice Address - Country:US
Practice Address - Phone:713-464-9100
Practice Address - Fax:713-468-6183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156678801Medicaid