Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jon Davis Pruett, MD

Individual provider Dermatology Physician · NPI 1023071933

Dr. Jon Davis Pruett, MD is a Dermatology in Dallas, Texas. Graduated from Louisiana State University School of Medicine in New Orleans in 2002, 24 years ago. Practices with Revival Dermatology PLLC, a 3-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
24
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
LA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

8201 Preston Rd Ste 440
Dallas, TX 75225-6209
Phone: (214) 675-3227
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence MD.15367R (LA)

Record details

NPI number1023071933
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 11, 2006
Last updated in NPPESFebruary 17, 2022
Certification dateFebruary 17, 2022
Mailing address8201 Preston Rd Ste 440, Dallas, TX 75225-6209

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2002 (24 years in practice)
Group practice Revival Dermatology Pllc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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