Provider Demographics
NPI:1184105348
Name:PRATHER, MICHAEL (PTA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:PRATHER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 WOODHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2749
Mailing Address - Country:US
Mailing Address - Phone:214-592-9721
Mailing Address - Fax:
Practice Address - Street 1:2000 W AUDIE MURPHY PKWY
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442-3427
Practice Address - Country:US
Practice Address - Phone:972-784-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2044014225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant