Provider Demographics
NPI:1609255330
Name:PRION, LLC
Entity Type:Organization
Organization Name:PRION, LLC
Other - Org Name:PRION
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SIERRA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:281-419-5530
Mailing Address - Street 1:2408 TIMBERLOCH PL
Mailing Address - Street 2:A-3
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1012
Mailing Address - Country:US
Mailing Address - Phone:281-419-5530
Mailing Address - Fax:877-795-8116
Practice Address - Street 1:2408 TIMBERLOCH PL
Practice Address - Street 2:A-3
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1012
Practice Address - Country:US
Practice Address - Phone:281-419-5530
Practice Address - Fax:832-747-7800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRION DURABLE MEDICAL EQUIPMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-27
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX807261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12743668OtherCAQH