Provider Demographics
NPI:1295556942
Name:CONTRERAS, LUIS (PHARMD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:
Other - Last Name:CONTRERAS PALACIOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2461 LARIMAR DR
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-1982
Mailing Address - Country:US
Mailing Address - Phone:469-343-6851
Mailing Address - Fax:
Practice Address - Street 1:2427 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-2625
Practice Address - Country:US
Practice Address - Phone:214-943-2883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74956183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist