Provider Demographics
NPI:1437486321
Name:PREATOR, MICHAEL ARLAN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ARLAN
Last Name:PREATOR
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 ALL SAINTS LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5537
Mailing Address - Country:US
Mailing Address - Phone:972-359-9777
Mailing Address - Fax:
Practice Address - Street 1:4130 LEGACY DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3404
Practice Address - Country:US
Practice Address - Phone:972-491-5677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist