Provider Demographics
NPI:1700097599
Name:MANJESHUSAR RAMAKRISHNA PRABHU MD.
Entity Type:Organization
Organization Name:MANJESHUSAR RAMAKRISHNA PRABHU MD.
Other - Org Name:POST OAKS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANJESHWAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:PRABHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-960-0344
Mailing Address - Street 1:2020 NORTH LOOP W
Mailing Address - Street 2:STE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8105
Mailing Address - Country:US
Mailing Address - Phone:713-960-0344
Mailing Address - Fax:713-871-9517
Practice Address - Street 1:2020 NORTH LOOP W
Practice Address - Street 2:STE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8105
Practice Address - Country:US
Practice Address - Phone:713-960-0344
Practice Address - Fax:713-871-9517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0213670-01Medicaid
TX0213670-01Medicaid