Individual
DR. KERRY C PRESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
2120 ANTILLEY RD, ABILENE, TX 79606-5211
(325) 695-2020
Mailing address
2120 ANTILLEY RD, ABILENE, TX 79606-5211
(325) 695-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T95927
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041128201
—
TX
01
—
410025679
RRMC
TX
01
—
751531889
TAX ID
—
01
—
81A049
BCBS
TX
Enumeration date
12/13/2005
Last updated
01/27/2010
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