Provider Demographics
NPI:1487635942
Name:HENRY, ADREAIN MAURICE (OD, MA, MBA)
Entity Type:Individual
Prefix:DR
First Name:ADREAIN
Middle Name:MAURICE
Last Name:HENRY
Suffix:
Gender:M
Credentials:OD, MA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 DATAPOINT DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2384
Mailing Address - Country:US
Mailing Address - Phone:210-283-6800
Mailing Address - Fax:210-283-6825
Practice Address - Street 1:9725 DATAPOINT DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2384
Practice Address - Country:US
Practice Address - Phone:210-283-6800
Practice Address - Fax:210-283-6825
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001637152W00000X
TX7505TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist