Provider Demographics
NPI:1639373749
Name:CONTRERAS, JUAN ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:ANTONIO
Last Name:CONTRERAS
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 1:4760 PRESTON RD STE 244-305
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8548
Mailing Address - Country:US
Mailing Address - Phone:832-413-1146
Mailing Address - Fax:972-428-3629
Practice Address - Street 1:4461 COIT RD
Practice Address - Street 2:SUITE 402
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0521
Practice Address - Country:US
Practice Address - Phone:214-297-0099
Practice Address - Fax:214-297-0096
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM6576207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM6576OtherSTATE LICENSE NUMBER
TX8J8608Medicare PIN
TXP00416302Medicare PIN
TXM6576OtherSTATE LICENSE NUMBER
TXCG0510Medicare PIN