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Individual

VENKATA SUBRAHMANYA SASTRY PRAYAGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
50 HILLCREST MEDICAL BLVD, WACO, TX 76712-8952
(254) 202-7204
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
(254) 215-9722

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
U1747
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02570501
NY
05
176975001
AR
Enumeration date
06/18/2006
Last updated
02/21/2023
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