Kyle Preston Lake

NPI #1548860737 in Denison, Texas

Provider Information

NPI Number: 1548860737
Entity Type: Individual
Name: Kyle Preston Lake
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Oct 28, 2020
Last Updated: Oct 29, 2020

Practice Location

Address: 401 N US HIGHWAY 75
City: Denison
State: Texas
ZIP Code: 75020-1595
Phone: (903) 465-8035

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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