MEDICARE: MICHAEL DAVID PRESTON MD

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	2084P0800X	Psychiatry Physician	T8311	TX
2	390200000X	Student in an Organized Health Care Education/Training Program		TX

General Provider Information

NPI Number	:	1053802520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DAVID PRESTON MD

Provider Business Mailing Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-8589
Country	:	US
Telephone Number	:	214-648-0784
Fax Number	:	214-648-1065

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-8589
Country	:	US
Telephone Number	:	214-648-0784
Fax Number	:	214-648-1065

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

Provider Enumeration Date	:	05/21/2018
Last Update Date	:	12/08/2025

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