Collin Thomas Bezely, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17675 Issued in TX

Practice address

590 Medical Center Drive
Fort Cavazos, TX 76544-5060

Phone

(254) 288-0509

NPI assigned

Oct 20, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1316729643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 MEDICAL CENTER DRIVE",
            "address_2": "BENNETT HEALTH CLINIC",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-288-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 MEDICAL CENTER DRIVE",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "765445060",
            "telephone_number": "254-288-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZELY",
        "first_name": "COLLIN",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-20",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate Lacey Barron Michel, DO, MPH
• John Lee Bazan, LCSW
• Kristen Beasley, MD
• Autumn Leigh-Ann Becker, D.M.D.
• Sara Bender, LCSW-S
• Maria Bienhoff
• George Bigalbal, DNP
• Sarah Elizabeth Boothe, LCSW
• Heather Brenner, LPC
• Logan Brookshire

• Physician Assistant in Fort Cavazos, TX
• Providers in Fort Cavazos, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.