Provider Demographics
NPI:1285630863
Name:O'HARA, ADRIANE A (PT)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANE
Middle Name:A
Last Name:O'HARA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 WYOMING SPGS
Mailing Address - Street 2:STE 400
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4304
Mailing Address - Country:US
Mailing Address - Phone:512-310-7246
Mailing Address - Fax:512-310-7667
Practice Address - Street 1:7200 WYOMING SPGS
Practice Address - Street 2:STE 400
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4304
Practice Address - Country:US
Practice Address - Phone:512-310-7246
Practice Address - Fax:512-310-7667
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1117778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
8T4165OtherBCBS
8C7858Medicare ID - Type Unspecified