Provider Demographics
NPI:1336564087
Name:EASTMAN, ADRIANA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 MEDICAL CENTER DR STE A&C-1
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1771
Mailing Address - Country:US
Mailing Address - Phone:469-850-2909
Mailing Address - Fax:
Practice Address - Street 1:3145 DENTON HWY
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76117-3710
Practice Address - Country:US
Practice Address - Phone:817-831-1078
Practice Address - Fax:817-831-1730
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108107235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist