Provider Demographics
NPI:1144661356
Name:SILUK, TODD R
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:R
Last Name:SILUK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17111 PRESTON ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1234
Mailing Address - Country:US
Mailing Address - Phone:866-972-8555
Mailing Address - Fax:866-491-5888
Practice Address - Street 1:17111 PRESTON RD STE 150
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1232
Practice Address - Country:US
Practice Address - Phone:888-588-1072
Practice Address - Fax:866-388-1488
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist