Provider Demographics
NPI:1538324603
Name:LONNIE G. ADIAN & ASSOCIATES, LLP
Entity Type:Organization
Organization Name:LONNIE G. ADIAN & ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:ADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:817-790-3198
Mailing Address - Street 1:5601 FM 2738
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-1162
Mailing Address - Country:US
Mailing Address - Phone:817-790-3198
Mailing Address - Fax:817-783-6507
Practice Address - Street 1:2850 E HIGHWAY 114
Practice Address - Street 2:
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-5302
Practice Address - Country:US
Practice Address - Phone:817-790-3198
Practice Address - Fax:817-783-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238232367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y725Medicare PIN