Provider Demographics
NPI:1063803666
Name:SOUTHWEST FSED PLLC
Entity type:Organization
Organization Name:SOUTHWEST FSED PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRASADA
Authorized Official - Middle Name:
Authorized Official - Last Name:NALLURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-527-3000
Mailing Address - Street 1:7940 CUSTER RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3179
Mailing Address - Country:US
Mailing Address - Phone:972-527-3000
Mailing Address - Fax:
Practice Address - Street 1:7940 CUSTER RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3179
Practice Address - Country:US
Practice Address - Phone:972-527-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care