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Individual

PRAKASH SHRESTHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4102 24TH ST STE 403, LUBBOCK, TX 79410-1804
(806) 725-7150
(806) 723-6136
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-4800
(806) 723-6532

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT194269
PA
207RI0200X
Infectious Disease Physician
Primary
R0129
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
582318YKT8
MEDICARE
TX
01
8GX844
BCBX
TX
Enumeration date
08/11/2009
Last updated
07/21/2022
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