Individual
SUJATHA LAKSHMI PRAYAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2400
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
N8237
TX
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
N8237
TX
Other
Enumeration date
06/05/2008
Last updated
02/10/2012
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