Individual
ADRIAN DENISE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1317 N HILLCREST DR, SULPHUR SPRINGS, TX 75482-2091
(903) 438-1110
(903) 438-1107
Mailing address
1317 N HILLCREST DR, SULPHUR SPRINGS, TX 75482-2091
(903) 438-1110
(903) 438-1107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04520
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281003801
—
TX
05
—
281003803
—
TX
01
—
752950731
TAX ID
TX
Enumeration date
08/17/2009
Last updated
01/23/2017
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