Individual
PRABHU DEEPAK KUMAR UDAYAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1850 HICKORY ST, STE 200F, ABILENE, TX 79601-2305
(325) 670-4590
(325) 670-4587
Mailing address
1850 HICKORY ST, STE 200F, ABILENE, TX 79601-2305
(325) 670-4590
(325) 670-4587
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
105531
MN
207RR0500X
Rheumatology Physician
54627
MN
207RR0500X
Rheumatology Physician
Primary
R9552
TX
390200000X
Student in an Organized Health Care Education/Training Program
RL10815
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PO1053458
MEDICARE RAILROAD
MN
Enumeration date
10/17/2008
Last updated
07/08/2021
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