Active NPI
Bryan Pruitt, MD
- Plastic Surgery Physician
- Dallas, TX
National Provider Identifier
1710015490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- H1403
- Practice address
- 8315 Walnut Hill LN
Suite 125
Dallas, TX 75231-4218 - Phone
- (214) 363-6000
- Fax
- (214) 363-0068
- NPI assigned
- Mar 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | H1403 | TX | Primary |
Addresses
Primary practice location
8315 Walnut Hill LN
Suite 125
Dallas, TX 75231-4218
Mailing address
8315 Walnut Hill LN
Suite 125
Dallas, TX 75231-4218
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 |
|---|---|---|---|
| H1403 | TX | MD | Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Care, P.a. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Mesquite, TX
- NPI 1225223605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1710015490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8315 WALNUT HILL LN",
"address_2": "SUITE 125",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8315 WALNUT HILL LN",
"address_2": "SUITE 125",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314218",
"telephone_number": "214-363-6000",
"fax_number": "214-363-0068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUITT",
"first_name": "BRYAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "TX",
"license": "H1403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.