| Adrienne L. Prentiss, Md Pa | |
|
1704 Tennison Pkwy Ste 100 Colleyville TX 76034-6297 | |
| (817) 251-1225 | |
| Not Available |
| Full Name | Adrienne L. Prentiss, Md Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1704 Tennison Pkwy Ste 100, Colleyville, Texas |
| Authorized Official Name and Position | Adrienne Prentiss (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8179398089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adrienne L. Prentiss, Md Pa 807 Crown Ct Keller TX 76248-5464 Ph: (817) 939-8089 | Adrienne L. Prentiss, Md Pa 1704 Tennison Pkwy Ste 100 Colleyville TX 76034-6297 Ph: (817) 251-1225 |
| NPI Number | 1205465200 |
|---|---|
| Provider Enumeration Date | 04/02/2020 |
| Last Update Date | 04/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205465200 | NPI | - | NPPES |
| H03548 | Other | TX | UPIN |
| 0060HP | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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