Provider Demographics
NPI:1598787327
Name:PRESKITT, JOHN T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:PRESKITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3410 WORTH ST
Mailing Address - Street 2:SUITE 235
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2003
Mailing Address - Country:US
Mailing Address - Phone:214-820-2302
Mailing Address - Fax:214-820-2303
Practice Address - Street 1:3410 WORTH ST
Practice Address - Street 2:SUITE 235
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2003
Practice Address - Country:US
Practice Address - Phone:214-820-2302
Practice Address - Fax:214-820-2303
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE4608208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097615105Medicaid
TX097615106Medicaid
TX8F8662OtherBCBS
TX097615104Medicaid
TX8CZ263OtherBCBSTX
TX097615104Medicaid
TX8C6039Medicare PIN
TX097615105Medicaid
TXTXB138537Medicare PIN
TXC20671Medicare UPIN