Provider Demographics
NPI:1639808777
Name:PRATT, GEOFFREY (DPT)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:
Last Name:PRATT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 MAPLESHADE LN APT 5221
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-5792
Mailing Address - Country:US
Mailing Address - Phone:662-422-6161
Mailing Address - Fax:
Practice Address - Street 1:2758 N GALLOWAY AVE STE 100
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6381
Practice Address - Country:US
Practice Address - Phone:972-681-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS73292251X0800X
LACP026485T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic