Active NPI
Edward J Prejean III, MD
- Anesthesiology Physician
- Dallas, TX
National Provider Identifier
1073555181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G6680
- Practice address
- 1935 Medical District Dr
Department of Anesthesiology
Dallas, TX 75235-7701 - Phone
- (214) 456-6393
- Fax
- (214) 456-7232
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G6680 | TX | Primary |
| Pediatric Anesthesiology Physician | 207LP3000X | G6680 | TX |
Addresses
Primary practice location
1935 Medical District Dr
Department of Anesthesiology
Dallas, TX 75235-7701
Mailing address
1935 Medical District Dr
Department of Anesthesiology
Dallas, TX 75235-7701
Phone (214) 456-6393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126459006 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G6680 | TX | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395014400000",
"number": "1073555181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1935 MEDICAL DISTRICT DR",
"address_2": "DEPARTMENT OF ANESTHESIOLOGY",
"city": "DALLAS",
"state": "TX",
"postal_code": "752357701",
"telephone_number": "214-456-6393",
"fax_number": "214-456-7232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1935 MEDICAL DISTRICT DR",
"address_2": "DEPARTMENT OF ANESTHESIOLOGY",
"city": "DALLAS",
"state": "TX",
"postal_code": "752357701",
"telephone_number": "214-456-6393",
"fax_number": "214-456-7232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREJEAN",
"first_name": "EDWARD",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2014-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "G6680",
"primary": true
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "TX",
"license": "G6680",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126459006",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
- Preeti Malladi, M.D. P.a.
- Preferred Care-Ride LLC
- Preferred Imaging at Casa Linda Plaza LTD
- Preferred Imaging at the Medical Center LTD
- Emily Anne Pregmon
- Lalith P. Premachandra, M.D.
- Premier Accessmd PLLC
- Premier Anesthesia Consultants
- Premier Anesthesia Goup LLP
- Premier Behavioral Health & Wellness LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.