Provider Demographics
NPI:1790422152
Name:PRADO, MEGAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:PRADO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 N GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-6992
Mailing Address - Country:US
Mailing Address - Phone:432-366-2868
Mailing Address - Fax:432-366-6616
Practice Address - Street 1:2745 N GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-6992
Practice Address - Country:US
Practice Address - Phone:432-366-2868
Practice Address - Fax:432-366-6616
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist