Provider Demographics
NPI:1598760449
Name:PRATUMRAT, PAIROJ (MD)
Entity Type:Individual
Prefix:DR
First Name:PAIROJ
Middle Name:
Last Name:PRATUMRAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 JOE RAMSEY BLVD E
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7727
Mailing Address - Country:US
Mailing Address - Phone:903-454-1722
Mailing Address - Fax:903-454-1750
Practice Address - Street 1:3900 JOE RAMSEY BLVD E
Practice Address - Street 2:SUITE E
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7727
Practice Address - Country:US
Practice Address - Phone:903-454-1722
Practice Address - Fax:903-454-1750
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8748207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX28714OtherAMERIGROUP
TX00HQ59OtherBCBS
TX3346OtherPARKLAND MEDICAID
TX4079663OtherAETNA
TX098812302Medicaid
TX28714OtherAMERIGROUP
TX098812302Medicaid