Provider Demographics
NPI:1366975336
Name:DHANASEKARAN, PRAGADEESWARI (MD)
Entity type:Individual
Prefix:DR
First Name:PRAGADEESWARI
Middle Name:
Last Name:DHANASEKARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 PRAIRIE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-3818
Mailing Address - Country:US
Mailing Address - Phone:972-544-9455
Mailing Address - Fax:972-544-9465
Practice Address - Street 1:2120 PRAIRIE DR STE 102
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-3818
Practice Address - Country:US
Practice Address - Phone:972-544-9455
Practice Address - Fax:972-544-9465
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS4126208D00000X, 208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program