MEDICARE: ADRIENNE WINIFRED COLSTON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA04612	TX
2	363AM0700X	Medical Physician Assistant	PA66038	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982643292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE WINIFRED COLSTON PA

Provider Business Mailing Address
First Line	:	5685 HIGH FOREST DR
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78132-3919
Country	:	US
Telephone Number	:	214-717-7780
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 LONE STAR PASS STE 46
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78264-3650
Country	:	US
Telephone Number	:	210-263-5766
Fax Number	:	210-263-5701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	05/16/2025

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Directions to “ ADRIENNE WINIFRED COLSTON PA” Practice Location

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