Individual
PRASHANTHI JAGANNATHAN GIRIDHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 645-2020
(214) 645-0078
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
P6394
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP1-0034031
TX
Other
Enumeration date
06/22/2009
Last updated
06/30/2014
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