MEDICARE: TAMARA LADA PRATT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	72802	TX

General Provider Information

NPI Number	:	1710862024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA LADA PRATT

Provider Business Mailing Address
First Line	:	3323 MCCUE RD APT 1142
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-7164
Country	:	US
Telephone Number	:	346-243-1212
Fax Number	:

Provider Business Practice Location Address
First Line	:	3323 MCCUE RD APT 1142
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-7164
Country	:	US
Telephone Number	:	346-243-1212
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	08/06/2025

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Directions to “ TAMARA LADA PRATT ” Practice Location

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