Provider Demographics
NPI:1831186030
Name:PRATT, STEPHEN EARL (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:EARL
Last Name:PRATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9101 LBJ FWY STE 710
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1912
Mailing Address - Country:US
Mailing Address - Phone:972-792-5700
Mailing Address - Fax:214-509-1170
Practice Address - Street 1:2021 N MACARTHUR BLVD STE 435
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2219
Practice Address - Country:US
Practice Address - Phone:972-445-9515
Practice Address - Fax:972-445-9414
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC51826207R00000X
TXP8086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX333711503Medicaid
CA00C518260Medicaid
TX333711505Medicaid
TX8EK561OtherBCBS
TXP01488180OtherRAILROAD MEDICARE
TX333711501Medicaid
TX879LPHOtherBCBS
TX343988YS0QMedicare PIN
TX333711501Medicaid