Provider Demographics
NPI:1669796488
Name:WARREN, ADRIANNA (DC)
Entity type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 E DOVE LOOP RD APT 326
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7294
Mailing Address - Country:US
Mailing Address - Phone:580-647-9106
Mailing Address - Fax:
Practice Address - Street 1:321 W SOUTHLAKE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6190
Practice Address - Country:US
Practice Address - Phone:817-488-4186
Practice Address - Fax:817-488-7417
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor