MEDICARE: DALLAS GERIATRICS ASSOCIATES, 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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	J6213	TX
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	H75575	OTHER	TX	MEDICARE UPIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00Y540	OTHER	TX	GROUP PTAN/ DALLAS COUNTY
3	L5100	OTHER	TX	TEXAS MEDICAL LICENSE #
4	00Y542	OTHER	TX	GROUP PTAN/ TARRANT COUNTY
5	00Y541	OTHER	TX	GROUP PTAN/ ELLIS & TARRANT COUNTY

General Provider Information

NPI Number	:	1629258058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS GERIATRICS ASSOCIATES, P.A

Provider Business Mailing Address
First Line	:	820 S MACARTHUR BLVD STE 105-392
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-4216
Country	:	US
Telephone Number	:	972-900-0747
Fax Number	:	972-393-5234

Provider Business Practice Location Address
First Line	:	4200 SHEPHERD LN
Second Line	:
City	:	BALCH SPRINGS
State	:	TX
Zip	:	75180-3423
Country	:	US
Telephone Number	:	214-325-1969
Fax Number	:	972-291-0019

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JYOTSNA S PRASAD
Credential	:	MD
Telephone Number	:	972-393-5234

Provider Enumeration Date	:	11/14/2007
Last Update Date	:	03/05/2026

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Directions to “DALLAS GERIATRICS ASSOCIATES, P.A ” Practice Location

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