Provider Demographics
NPI:1356515787
Name:PRASAD, SENDIL KUMAR HARI (MD)
Entity type:Individual
Prefix:DR
First Name:SENDIL KUMAR HARI
Middle Name:
Last Name:PRASAD
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 1:146 E HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-4169
Mailing Address - Country:US
Mailing Address - Phone:979-848-6050
Mailing Address - Fax:979-848-6051
Practice Address - Street 1:132 E HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-4112
Practice Address - Country:US
Practice Address - Phone:979-849-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445147207R00000X
PAMT190374207RC0000X
TX45075207RC0000X
ARE 6631208M00000X
TXQ5536207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR186040001Medicaid
5AF90Medicare PIN