Individual
PRAKASH R NANCHERLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 PALO ALTO RD, SUITE 200, SAN ANTONIO, TX 78211-3758
(210) 403-0765
(210) 547-9270
Mailing address
7142 SAN PEDRO AVE, SUITE 120, SAN ANTONIO, TX 78216-6254
(210) 661-5622
(210) 395-4012
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G7697
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123185405
—
TX
01
—
P01258507
MEDICARE RAIL ROAD
TX
Enumeration date
07/07/2005
Last updated
08/13/2015
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