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Organization

DALLAS GERIATRICS ASSOCIATES, P.A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JYOTSNA S PRASAD MD (PRESIDENT)
(972) 393-5234
Entity
Organization

Contact information

Practice address
4200 SHEPHERD LN, BALCH SPRINGS, TX 75180-3423
(214) 325-1969
(702) 977-1496
Mailing address
820 S MACARTHUR BLVD STE 105-392, COPPELL, TX 75019-4216
(972) 900-0747
(972) 393-5234

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
J6213
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00Y540
GROUP PTAN/ DALLAS COUNTY
TX
01
00Y541
GROUP PTAN/ ELLIS & TARRANT COUNTY
TX
01
00Y542
GROUP PTAN/ TARRANT COUNTY
TX
01
H75575
MEDICARE UPIN
TX
01
L5100
TEXAS MEDICAL LICENSE #
TX
Enumeration date
11/14/2007
Last updated
05/15/2026
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