Healthcare Provider Details

I. General information

NPI: 1932096849
Provider Name (Legal Business Name): ADRIAN BARRERA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 RIDGE COUNTRY ST
SAN ANTONIO TX
78247-3463
US

IV. Provider business mailing address

3700 RIDGE COUNTRY ST
SAN ANTONIO TX
78247-3463
US

V. Phone/Fax

Practice location:
  • Phone: 210-598-7212
  • Fax: 866-811-2590
Mailing address:
  • Phone: 210-598-7212
  • Fax: 866-811-2590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: