Organization Active NPI

Colleyville Psychiatric Associates PLLC

  • Medical Specialty Clinic/Center
  • Colleyville, TX
National Provider Identifier
1053203208
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
COLLEYVILLE PSYCHIATRIC ASSOCIATES PLLC
Practice address
4218 Gateway Dr Ste 140
Colleyville, TX 76034-7902
Phone
(682) 451-7668
Fax
(682) 258-0114
NPI assigned
Jul 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alexander Gordon ColeNPI 1013303163
Title
Manager
Phone
(682) 451-7668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

4218 Gateway Dr Ste 140
Colleyville, TX 76034-7902

Mailing address

4218 Gateway Dr Ste 140
Colleyville, TX 76034-7902
Phone (682) 451-7668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250902001161 TX Part B Supplier - Clinic/Group Practice 2466953351 Receives reassigned benefits from 1 practitioner
Practice locations: Colleyville, TX

National Provider Directory

National Provider Directory

Locations

4218 Gateway Dr
Ste 140
Colleyville, TX 76034
Phone (682) 451-7668

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770940800000",
    "number": "1053203208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4218 GATEWAY DR STE 140",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760347902",
            "telephone_number": "682-451-7668",
            "fax_number": "682-258-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4218 GATEWAY DR STE 140",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760347902",
            "telephone_number": "682-451-7668",
            "fax_number": "682-258-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEYVILLE PSYCHIATRIC ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-21",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "682-451-7668"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.