Provider Demographics
NPI:1740092709
Name:PRADO HERRERA, ABDIEL
Entity type:Individual
Prefix:MR
First Name:ABDIEL
Middle Name:
Last Name:PRADO HERRERA
Suffix:
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 1:4024 N STORY RD APT 825
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-8801
Mailing Address - Country:US
Mailing Address - Phone:786-420-8152
Mailing Address - Fax:
Practice Address - Street 1:2000 ESTERS RD STE 120
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-8020
Practice Address - Country:US
Practice Address - Phone:786-420-8152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
24-124246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant