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Individual

DR. HIMA B PRABHAKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
800 SPRUCE STREET, SUITE 600, PHILADELPHIA, PA 19107-6130
(215) 829-6079
(210) 616-7799
Mailing address
800 SPRUCE STREET, SUITE 600, PHILADELPHIA, PA 19107-6130
(215) 829-6079
(210) 616-7799

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD442129
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1872640-03
TX
01
1872640-04
MEDICAID - STRIC
TX
01
1872640-05
MEDICAID - CSHCN
TX
01
8L5908
MEDICARE - STRIC
TX
01
8S3959
BCBS PROVIDER #
TX
01
M8259
TEXAS LICENSE
TX
01
P00692121
RR MEDICARE - STRG
TX
01
P00692125
RR MEDICARE - STRIC
TX
Enumeration date
02/17/2006
Last updated
11/16/2016
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