Individual
PRASHANTH JOSHUA JAISANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(301) 221-5697
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0102208322
VA
Other
Enumeration date
04/05/2022
Last updated
02/27/2024
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