Provider Demographics
NPI:1649940958
Name:MANJESHWAR RAMAKRISHNA PRABHU MD
Entity type:Organization
Organization Name:MANJESHWAR RAMAKRISHNA PRABHU MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANJESHWAR
Authorized Official - Middle Name:RAMAKRISHNA
Authorized Official - Last Name:PRABHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-960-0344
Mailing Address - Street 1:1147 BRITTMOORE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-5039
Mailing Address - Country:US
Mailing Address - Phone:713-960-0344
Mailing Address - Fax:
Practice Address - Street 1:1147 BRITTMOORE RD STE 4
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-5039
Practice Address - Country:US
Practice Address - Phone:713-960-0344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty