Organization
ADRIENNE L. PRENTISS, MD PA
Active
Other names
PRENTISS FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADRIENNE PRENTISS MD (OWNER/PHYSICIAN)
(817) 939-8089
Entity
Organization
Contact information
Practice address
1704 TENNISON PKWY STE 100, COLLEYVILLE, TX 76034-6297
(817) 251-1225
Mailing address
807 CROWN CT, KELLER, TX 76248-5464
(817) 939-8089
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060HP
BCBS
TX
01
—
H03548
UPIN
TX
Enumeration date
04/02/2020
Last updated
04/02/2020
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