Provider Demographics
NPI:1558617076
Name:PRASANNAK N KUMAR MD F R C S PA
Entity Type:Organization
Organization Name:PRASANNAK N KUMAR MD F R C S PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PRASANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-589-2517
Mailing Address - Street 1:3813 DIAMOND LOCH W
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8729
Mailing Address - Country:US
Mailing Address - Phone:817-589-2517
Mailing Address - Fax:
Practice Address - Street 1:2712 HURSTVIEW DR
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2402
Practice Address - Country:US
Practice Address - Phone:817-589-2512
Practice Address - Fax:817-284-7021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility