Individual ProviderPrasanna KumarFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1500 S Main St, Fort Worth, TX 76104-4917(817) 921-3431PECOS EnrollmentBased on the most recent information from CMS, provider Prasanna Kumar is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1215957410Provider TypeIndividualFull NameKumar, PrasannaTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date7/20/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1500 S Main St, Fort Worth, TX 76104-4917Phone(817) 921-3431FaxUnlisted FaxMailing LocationMailing Address1500 S Main St, Fort Worth, TX 76104-4917Phone(817) 921-3431FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseF6274TexasProvider IdentifiersIDDescriptionIssuerID139815821DescriptionMedicaidIssuerUnlistedTexas