Individual
SUJIT PRABHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
L5878
TX
2086X0206X
Surgical Oncology Physician
L5878
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140008274
RR MEDICARE
TX
05
—
157703301
—
TX
01
—
8H3242
BCBS
TX
Enumeration date
09/16/2006
Last updated
03/02/2023
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