Provider Demographics
NPI:1518446475
Name:PRASAD, DENNIS S
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:S
Last Name:PRASAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 E SONTERRA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3989
Mailing Address - Country:US
Mailing Address - Phone:210-593-5740
Mailing Address - Fax:
Practice Address - Street 1:155 E SONTERRA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3989
Practice Address - Country:US
Practice Address - Phone:210-593-5740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-11
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist