Provider Demographics
NPI:1861572711
Name:PRATKA, CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:PRATKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1501 E MOCKINGBIRD LN
Mailing Address - Street 2:STE 101
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2178
Mailing Address - Country:US
Mailing Address - Phone:361-573-6291
Mailing Address - Fax:361-576-2434
Practice Address - Street 1:1501 E MOCKINGBIRD LN
Practice Address - Street 2:#101
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2155
Practice Address - Country:US
Practice Address - Phone:361-513-6291
Practice Address - Fax:361-576-2434
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK3629207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87W156OtherBLUE CROSS
TX046153501Medicaid
TX742710179A028OtherCHAMPUS
TXMDK3629OtherWORKERS COMPENSATION
TX046153501Medicaid
TX046153501Medicaid