Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | N6068 | TX |
NPI | 1225246747 |
---|---|
Provider Name | Dr. Adrienne M Tinana |
First Address | Skyland, NC 28776-2392 |
Second Address | Corpus Christi, TX 78413-5542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 16/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
217628101 | (05) | TX |
TXB158030 | MEDICARE PTAN (01) | TX |