Individual provider · Type 1 NPI
Dave Prakash, MD
Clinic/Center · Bossier City, LA
NPI number
1912201435
Active
Practice location
5526 Lake Side Dr
Bossier City, LA 71111-5504
Mailing address
PO Box 184
Barksdale Afb, LA 71110-0184
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | 234586 (NY) |
Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
About NPI 1912201435
Dave Prakash, MD's National Provider Identifier is 1912201435, issued on Dec 23, 2010. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Bossier City, LA. The record was last updated on Dec 23, 2010.