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NPI Code Detail

MEDICARE: JAN CARLOS PRAZAK MD

MEDICARE:   JAN CARLOS PRAZAK  MD
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
1207RG0100XGastroenterology Physician4301079500MI

General Provider Information

NPI Number : 1649488222
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAN CARLOS PRAZAK MD
Provider Business Mailing Address
First Line : 621 CAMDEN STREET
Second Line : SUITE 202
City : SAN ANTONIO
State : TX
Zip : 78215-1639
Country : US
Telephone Number : 210-253-3422
Fax Number : 210-227-9833
Provider Business Practice Location Address
First Line : 621 CAMDEN STREET
Second Line : SUITE 202
City : SAN ANTONIO
State : TX
Zip : 78215-1639
Country : US
Telephone Number : 210-253-3422
Fax Number : 210-227-9833
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 11/14/2013

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Directions to “ JAN CARLOS PRAZAK MD” Practice Location

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