Provider Demographics
NPI:1851445092
Name:PRATI, JUAN MARTIN (OD)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:MARTIN
Last Name:PRATI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 BAY AREA BLVD
Mailing Address - Street 2:STE E
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2538
Mailing Address - Country:US
Mailing Address - Phone:281-488-2020
Mailing Address - Fax:281-488-2009
Practice Address - Street 1:1234 BAY AREA BLVD
Practice Address - Street 2:STE E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2538
Practice Address - Country:US
Practice Address - Phone:281-488-2020
Practice Address - Fax:281-488-2009
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6614TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist