Provider Demographics
NPI:1699154328
Name:SIERRA, ADRIENNE LEE (CEO)
Entity type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:LEE
Last Name:SIERRA
Suffix:
Gender:
Credentials:CEO
Other - Prefix:
Other - First Name:CBS
Other - Middle Name:MEDICAL
Other - Last Name:SUPPLIES, LLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CEO
Mailing Address - Street 1:24430 INTERSTATE 45 STE B
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2354
Mailing Address - Country:US
Mailing Address - Phone:281-419-5530
Mailing Address - Fax:281-990-6740
Practice Address - Street 1:24430 INTERSTATE 45 STE B
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2354
Practice Address - Country:US
Practice Address - Phone:281-419-5530
Practice Address - Fax:281-990-6740
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001968246Z00000X
332900000X, 335V00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No332900000XSuppliersNon-Pharmacy Dispensing Site
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1609542992OtherNPI
TX1699154328OtherNPI
TX1154410967OtherMD NPI
TX494630301Medicaid