Provider Demographics
NPI:1003372418
Name:DO, ADRIENNE (PA-C)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11819 KEY BISCAYNE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4090
Mailing Address - Country:US
Mailing Address - Phone:713-505-6194
Mailing Address - Fax:
Practice Address - Street 1:902 FROSTWOOD DR STE 155
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2449
Practice Address - Country:US
Practice Address - Phone:832-530-4159
Practice Address - Fax:713-467-6389
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12403363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant