Provider Demographics
NPI:1164656872
Name:NARA PRAVAT D.O. P.A.
Entity Type:Organization
Organization Name:NARA PRAVAT D.O. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NARA
Authorized Official - Middle Name:PRAPAN
Authorized Official - Last Name:PRAVAT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-821-5026
Mailing Address - Street 1:15136 MAJORCA ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-6423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15136 MAJORCA ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-6423
Practice Address - Country:US
Practice Address - Phone:817-821-5026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-08
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty