NPIMap

Organization Active NPI

Collom & Carney Clinic Association

  • Family Medicine Physician
  • Texarkana, TX
National Provider Identifier
1629378963
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COLLOM & CARNEY CLINIC ASSOCIATION
Practice address
4110 Richmond PL
Texarkana, TX 75503-0001
Phone
(903) 831-6312
Fax
(903) 838-3613
NPI assigned
Nov 2, 2010
Last updated
Apr 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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

Authorized official

Name
Mary E Dwight
Title
Asst Administrator of Patient Serv
Phone
(903) 614-3282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4110 Richmond PL
Texarkana, TX 75503-0001

Mailing address

5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766
Phone (903) 614-3000

National Provider Directory

National Provider Directory
Tax ID family
Collom and Carney Clini20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1629378963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 COWHORN CREEK RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755039766",
            "telephone_number": "903-614-3000",
            "fax_number": "903-614-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 RICHMOND PL",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755030001",
            "telephone_number": "903-831-6312",
            "fax_number": "903-838-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLOM & CARNEY CLINIC ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "DWIGHT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ASST ADMINISTRATOR OF PATIENT SERV",
        "authorized_official_telephone_number": "903-614-3282"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.