Provider Demographics
NPI:1851680300
Name:PRASAD, SONAL PATEL (MD)
Entity type:Individual
Prefix:
First Name:SONAL
Middle Name:PATEL
Last Name:PRASAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONAL
Other - Middle Name:A
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:DEPARTMENT OF PSYCHIATRY UT SOUTHWESTERN
Mailing Address - Street 2:5323 HARRY HINES BLVD
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-8589
Mailing Address - Country:US
Mailing Address - Phone:214-456-1383
Mailing Address - Fax:214-456-1383
Practice Address - Street 1:DEPARTMENT OF PSYCHIATRY UT SOUTHWESTERN
Practice Address - Street 2:5323 HARRY HINES BLVD
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8589
Practice Address - Country:US
Practice Address - Phone:214-456-1383
Practice Address - Fax:214-456-1383
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ37712084P0804X, 2084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program