Healthcare Provider Details

I. General information

NPI: 1952435141
Provider Name (Legal Business Name): JOSEPH ANTHONY PRANULIS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 CLARKSVILLE ST
PARIS TX
75460-6027
US

IV. Provider business mailing address

1914 FAULKNER DR
ROWLETT TX
75088-5956
US

V. Phone/Fax

Practice location:
  • Phone: 903-737-4521
  • Fax: 903-737-3848
Mailing address:
  • Phone: 972-475-0943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberH3144
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberH3144
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: