Organization
NORTH EAST HOSPITALIST MANAGEMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAKASH HEGDE M.D. (PRESIDENT CEO)
(817) 293-4800
Entity
Organization
Contact information
Practice address
11803 SOUTH FWY STE 201, BURLESON, TX 76028-7029
(817) 293-4800
(817) 293-4808
Mailing address
11803 SOUTH FWY STE 201, BURLESON, TX 76028-7029
(817) 293-4800
(817) 293-4808
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
L7415
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162179002
—
AR
05
—
184028201
—
TX
01
—
36NP
TEXAS BLUE CROSS
TX
01
—
5F660
ARKANSAS BLUE CROSS
AR
01
—
DF0981
RAILROAD MEDICARE
TX
Enumeration date
06/03/2006
Last updated
09/25/2014
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