MEDICARE: HENRY M PRESLAR III

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter		TX
2	237700000X	Hearing Instrument Specialist	50460	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881885507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY M PRESLAR III

Provider Business Mailing Address
First Line	:	6700 WASHINGTON AVE S
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3405
Country	:	US
Telephone Number	:	612-351-1529
Fax Number	:

Provider Business Practice Location Address
First Line	:	1144 W DALLAS ST
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-2208
Country	:	US
Telephone Number	:	936-756-4141
Fax Number	:	936-756-7241

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	02/22/2019

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