Provider Demographics
NPI:1649406281
Name:PRAKASH, ANAND (MS; MD)
Entity Type:Individual
Prefix:
First Name:ANAND
Middle Name:
Last Name:PRAKASH
Suffix:
Gender:M
Credentials:MS; MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3315 COLORADO BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6885
Mailing Address - Country:US
Mailing Address - Phone:940-320-1708
Mailing Address - Fax:940-565-5457
Practice Address - Street 1:850 5TH AVE E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-7419
Practice Address - Country:US
Practice Address - Phone:205-348-1770
Practice Address - Fax:205-348-5145
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2021-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXS9974207RN0300X
ALMD31994208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist