Individual
DR. ADRIENNE L PRENTISS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 W COLLEGE ST, STE 510, GRAPEVINE, TX 76051-3589
(817) 251-1225
(817) 251-1228
Mailing address
1600 W COLLEGE ST, STE 510, GRAPEVINE, TX 76051-3589
(817) 251-1225
(817) 251-1228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K8817
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060HP
BCBS
TX
Enumeration date
06/23/2005
Last updated
07/08/2007
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