Provider Demographics
NPI:1083658751
Name:DEEM, ADRIANNE (MD)
Entity type:Individual
Prefix:DR
First Name:ADRIANNE
Middle Name:
Last Name:DEEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 HARRIS PKWY
Mailing Address - Street 2:#245
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4124
Mailing Address - Country:US
Mailing Address - Phone:817-346-5336
Mailing Address - Fax:817-346-5366
Practice Address - Street 1:1275 W. TERRELL AVE
Practice Address - Street 2:STE 200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104
Practice Address - Country:US
Practice Address - Phone:817-250-7035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3838207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82954XOtherBC/BS
TX7507354OtherAETNA HMO
TX160059984OtherMEDICARE RAILROAD
TX150755001Medicaid