Healthcare Provider Details

I. General information

NPI: 1710568670
Provider Name (Legal Business Name): PATRICK JAMES PRAZAK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16811 SOUTHWEST FWY STE 200
SUGAR LAND TX
77479-4728
US

IV. Provider business mailing address

16811 SOUTHWEST FWY STE 200
SUGAR LAND TX
77479-4728
US

V. Phone/Fax

Practice location:
  • Phone: 281-690-4678
  • Fax:
Mailing address:
  • Phone: 281-690-4678
  • Fax: 281-737-0999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number3046123513
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberU2293
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: