Individual
SMRITI PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4120 SAN ANTONIO ST., ODESSA, TX 79765
(432) 333-9200
(432) 333-9300
Mailing address
4120 SAN ANTONIO ST, ODESSA, TX 79765
(432) 333-9200
(432) 333-9300
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
V4728
TX
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
V4728
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049204
—
OH
Enumeration date
04/28/2020
Last updated
10/29/2025
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