Provider Demographics
NPI:1013443274
Name:RAHUL PRAKASH, M.D., P.A.
Entity Type:Organization
Organization Name:RAHUL PRAKASH, M.D., P.A.
Other - Org Name:GREENHOUSE VASCULAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-464-9100
Mailing Address - Street 1:3001 PALM HARBOR BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1930
Mailing Address - Country:US
Mailing Address - Phone:727-474-0090
Mailing Address - Fax:
Practice Address - Street 1:2222 GREENHOUSE RD
Practice Address - Street 2:SUITE 15
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7287
Practice Address - Country:US
Practice Address - Phone:713-464-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAHUL PRAKASH, M.D., P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-10
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00631602Medicare PIN
TX8G7263Medicare PIN