Provider Demographics
NPI:1982834123
Name:VEGA, ADRIAN (OTR)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:VEGA
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-5205
Mailing Address - Country:US
Mailing Address - Phone:210-241-5792
Mailing Address - Fax:
Practice Address - Street 1:137 N HIGH ST
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-5205
Practice Address - Country:US
Practice Address - Phone:210-241-5792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113061225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist