Jan Karel Petric, CO

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

2128 Issued in TX

Practice address

6011 Harry Hines Blvd
Dallas, TX 75235-5386

Phone

(214) 645-8250

NPI assigned

Feb 2, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1275239113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 HESTER AVE APT 509",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355386",
            "telephone_number": "214-645-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIC",
        "first_name": "JAN KAREL",
        "credential": "CO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "TX",
            "license": "2128",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "TX",
            "license": "2128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan Petrasek, M.D., PH.D.
• Priscilla Louise Petrash, P.A.-C
• Rodica Elena Petrea, M.D.
• Tyler Robert Petree, DO
• Laura Petrey, M.D.
• Heather Socha Petrie, RN, CPNP-PC
• Chelsea L Petro, PA
• Toby Carl Petro, D.D.S.
• Sandra M Petrocchi, DDS
• Dianne Lynn Petrone, M.D.

• Prosthetist in Dallas, TX
• Providers in Dallas, TX by specialty
• Prosthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.