Provider Demographics
NPI:1285248948
Name:PRESTON, ANDREA DAWN (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:DAWN
Last Name:PRESTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 ARROYO VISTA PL
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-1202
Mailing Address - Country:US
Mailing Address - Phone:806-626-2647
Mailing Address - Fax:806-353-6387
Practice Address - Street 1:4504 S WESTERN ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-8042
Practice Address - Country:US
Practice Address - Phone:806-353-1371
Practice Address - Fax:806-353-6387
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist