Colleen A. Pendergrass, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00932 Issued in TX

Practice address

6124 W Parker Rd
Suite 536
Plano, TX 75093-8122

Phone

(972) 943-8440

Fax

(972) 943-8348

NPI assigned

Feb 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790828739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35629",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752350629",
            "telephone_number": "214-424-2213",
            "fax_number": "214-231-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6124 W PARKER RD",
            "address_2": "SUITE 536",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938122",
            "telephone_number": "972-943-8440",
            "fax_number": "972-943-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "COLLEEN",
        "middle_name": "A.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peltier Family Counseling, PLLC
• Diana Pemberton
• Sofia Concepcion Pena
• Eslynn Penamante-Lum, MD
• Patricia Susanne Pencsak, PT
• Cory Penfold, ATC
• Adrian Elisse Pennick, M.A., BCBA
• Niya D Pennie, RN
• Susan Pennington, CRNFA
• Penntex Services, LTD. (LifeCare of Texas)

• Physician Assistant in Plano, TX
• Providers in Plano, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.