Provider Demographics
NPI:1821560103
Name:CAIN, PRESTON JR
Entity Type:Individual
Prefix:
First Name:PRESTON
Middle Name:
Last Name:CAIN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 RUE KATHERINE
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-8994
Mailing Address - Country:US
Mailing Address - Phone:214-924-4284
Mailing Address - Fax:
Practice Address - Street 1:207 RUE KATHERINE
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-8994
Practice Address - Country:US
Practice Address - Phone:214-924-4284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health