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General NPI Number Information
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NPI Number | 1982643292
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Entity Type | Individual
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Provider Name | ADRIENNE WINIFRED COLSTON PA
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Gender | Female
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 1 LONE STAR PASS STE 46
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City | SAN ANTONIO
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State | TX
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Zip | 78264-3650
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Country | US
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Telephone | 210-263-5766
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Fax | 210-263-5701
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Provider Business Mailing Address
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Address Line | 5685 HIGH FOREST DR
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City | NEW BRAUNFELS
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State | TX
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Zip | 78132-3919
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Country | US
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Telephone | 214-717-7780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA04612
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA66038
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License Number State | CA
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