Organization Active NPI

Pruna Family Medicine PLLC

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1992299457
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N7330 Issued in TX
Legal business name
PRUNA FAMILY MEDICINE PLLC
Practice address
13140 Coit Rd Ste 312
Dallas, TX 75240-5703
Phone
(972) 598-0270
Fax
(972) 598-0272
NPI assigned
Jun 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
Dr. Ernesto Pruna, MDNPI 1932305828
Title
Medical Doctor/Physician
Phone
(972) 598-0270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X N7330 TX Primary

Addresses

Primary practice location

13140 Coit Rd Ste 312
Dallas, TX 75240-5703

Mailing address

13140 Coit Rd Ste 312
Dallas, TX 75240-5703
Phone (972) 598-0270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190524000600 TX Part B Supplier - Clinic/Group Practice 7810241734 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2160429Pruna Family Medicine, PLLC13140 Coit Rd Suite 312, Dallas, TX 75240Certificate of waiverJan 9, 2027

National Provider Directory

National Provider Directory

Locations

8140 Walnut Hill Ln
Ste 102
Dallas, TX 75231
Phone (214) 267-1400

13140 Coit Rd
Ste 312
Dallas, TX 75240
Phone (832) 754-3450

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1992299457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13140 COIT RD STE 312",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752405703",
            "telephone_number": "972-598-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13140 COIT RD STE 312",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752405703",
            "telephone_number": "972-598-0270",
            "fax_number": "972-598-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUNA FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-19",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "PRUNA",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_title_or_position": "MEDICAL DOCTOR/PHYSICIAN",
        "authorized_official_telephone_number": "972-598-0270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N7330",
            "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 Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.