Provider Demographics
NPI:1649488222
Name:PRAZAK, JAN CARLOS (MD)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:CARLOS
Last Name:PRAZAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:621 CAMDEN STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1639
Mailing Address - Country:US
Mailing Address - Phone:210-253-3422
Mailing Address - Fax:210-227-9833
Practice Address - Street 1:621 CAMDEN STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1639
Practice Address - Country:US
Practice Address - Phone:210-253-3422
Practice Address - Fax:210-227-9833
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2013-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301079500207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology