Provider Demographics
NPI:1851545776
Name:ADRIAN, DON ARTHUR (PTA)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:ARTHUR
Last Name:ADRIAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SISTERDALE RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-7031
Mailing Address - Country:US
Mailing Address - Phone:208-421-2077
Mailing Address - Fax:
Practice Address - Street 1:6 SISTERDALE RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-7031
Practice Address - Country:US
Practice Address - Phone:208-421-2077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2034833225200000X
AZ0272A225200000X
CAAT6600225200000X
FLPTA20242225200000X
IDPTA2293225200000X
MT2140PTA225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant