Provider Demographics
NPI:1881076891
Name:HARMON, PRESTON (MD)
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:
Last Name:HARMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7668 ELDORADO PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5753
Mailing Address - Country:US
Mailing Address - Phone:214-817-4225
Mailing Address - Fax:972-674-2788
Practice Address - Street 1:1701 N US HIGHWAY 75 STE 100
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2838
Practice Address - Country:US
Practice Address - Phone:214-817-4225
Practice Address - Fax:972-674-2788
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.134144207P00000X
KS94-08768207R00000X
TXS27932081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0314411Medicaid