Provider Demographics
NPI:1861172108
Name:PRASHAD, ROSE LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:ROSE
Middle Name:LEE
Last Name:PRASHAD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 BUCKEYE TRL., LAGRANGE TX 78945
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945
Mailing Address - Country:US
Mailing Address - Phone:254-981-4990
Mailing Address - Fax:
Practice Address - Street 1:301 BUCKEYE TRL., LAGRANGE TX 78945
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945
Practice Address - Country:US
Practice Address - Phone:254-981-4990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program