Provider Demographics
NPI:1831538321
Name:CONTRERAS, DANIEL (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5305 KESWICK AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-2144
Mailing Address - Country:US
Mailing Address - Phone:361-815-6675
Mailing Address - Fax:
Practice Address - Street 1:5049 PRESTON RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7401
Practice Address - Country:US
Practice Address - Phone:214-387-9505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist