MEDICARE: NARA PRAVAT D.O. P.A.

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1164656872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NARA PRAVAT D.O. P.A.

Provider Business Mailing Address
First Line	:	6923 ROYAL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-4214
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 W MOCKINGBIRD LN STE 420
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4973
Country	:	US
Telephone Number	:	214-267-0101
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. NARA PRAPAN PRAVAT
Credential	:	D.O.
Telephone Number	:	817-821-5026

Provider Enumeration Date	:	05/08/2009
Last Update Date	:	03/05/2025

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