Provider Demographics
NPI:1215040779
Name:AGUSALA, PRATAP (MD)
Entity type:Individual
Prefix:
First Name:PRATAP
Middle Name:
Last Name:AGUSALA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:255 ED ENGLISH DR STE B
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8027
Mailing Address - Country:US
Mailing Address - Phone:281-890-4886
Mailing Address - Fax:281-894-2247
Practice Address - Street 1:255 ED ENGLISH DR STE B
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8027
Practice Address - Country:US
Practice Address - Phone:281-890-4886
Practice Address - Fax:281-894-2247
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN8751207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease