Provider Demographics
NPI:1659189553
Name:PRAZAK, MARI (DPT)
Entity type:Individual
Prefix:
First Name:MARI
Middle Name:
Last Name:PRAZAK
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15708 OAK POINTE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-1560
Mailing Address - Country:US
Mailing Address - Phone:817-235-0956
Mailing Address - Fax:
Practice Address - Street 1:511 W FM 544 STE 208
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4629
Practice Address - Country:US
Practice Address - Phone:972-578-0306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2025-03-03
Deactivation Date:2024-12-23
Deactivation Code:
Reactivation Date:2025-03-03
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic