Provider Demographics
NPI:1942596077
Name:RAWLA, PRASHANTH REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:PRASHANTH REDDY
Middle Name:
Last Name:RAWLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8117 PRESTON RD
Practice Address - Street 2:SUITE 800
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6332
Practice Address - Country:US
Practice Address - Phone:214-666-9528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IAMD-14659207R00000X
VA0101257511207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program