Individual
MR. PRASHANTH R ANUMANDLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP-BC, RN
Contact information
Practice address
6550 FANNIN ST, SUITE 1901, SMITH TOWER, HOUSTON, TX 77030
(713) 441-1100
(713) 790-2643
Mailing address
6550 FANNIN ST, SUITE 1901, SMITH TOWER, HOUSTON, TX 77030-2717
(713) 441-1100
(713) 790-2643
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
139357
WI
363L00000X
Nurse Practitioner
761283
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP116895
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1822558
—
LA
05
—
199955901
—
TX
05
—
199955902
—
TX
05
—
199955904
—
TX
05
—
41191300
—
WI
01
—
8Y9191
BLUE CROSS BLUE SHIELD
TX
01
—
P00741122
RAILROAD MEDICARE
TX
01
—
P01037103
RR MEDICARE
TX
Enumeration date
08/30/2006
Last updated
06/20/2018
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