Provider Demographics
NPI:1396875837
Name:HERRING, ADRIENNE MARIE (PT)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MARIE
Last Name:HERRING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12708 RIATA VISTA CIR
Mailing Address - Street 2:STE #A126
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-7167
Mailing Address - Country:US
Mailing Address - Phone:512-637-2002
Mailing Address - Fax:
Practice Address - Street 1:9101 BURNET RD
Practice Address - Street 2:STE #103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5254
Practice Address - Country:US
Practice Address - Phone:512-248-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11631002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics