Provider Demographics
NPI:1396906673
Name:PRAVAT, NARA PRAPAN (DO)
Entity type:Individual
Prefix:DR
First Name:NARA
Middle Name:PRAPAN
Last Name:PRAVAT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:NARA
Other - Middle Name:
Other - Last Name:PATTRANUPRAVAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:11412 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3104
Mailing Address - Country:US
Mailing Address - Phone:817-821-5026
Mailing Address - Fax:972-421-1846
Practice Address - Street 1:1420 W MOCKINGBIRD LN STE 420
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4973
Practice Address - Country:US
Practice Address - Phone:214-267-0101
Practice Address - Fax:214-267-8787
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2738208VP0014X, 2081P2900X
DCDO034259390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program