Provider Demographics
NPI:1932605839
Name:PRABHU, NAYANA (MD)
Entity type:Individual
Prefix:DR
First Name:NAYANA
Middle Name:
Last Name:PRABHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NAYANA
Other - Middle Name:
Other - Last Name:NAYAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8900 INDEPENDENCE PKWY APT NO14104
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5235
Mailing Address - Country:US
Mailing Address - Phone:469-740-4460
Mailing Address - Fax:
Practice Address - Street 1:2350 N STEMMONS FWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2700
Practice Address - Country:US
Practice Address - Phone:214-456-2768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-01
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXV36802084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program