Provider Type Icon

COLLOM & CARNEY CLINIC ASSOCIATION NPI 1700100104


NPI Information

NPI: 1700100104
Provider Name: COLLOM & CARNEY CLINIC ASSOCIATION
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D0938567

Address:
128 N ELLIS ST
NEW BOSTON, TX
ZIP 75570
Phone: (903) 628-1104
Get Directions

COLLOM & CARNEY CLINIC ASSOCIATION is a family medicine in New Boston, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. COLLOM & CARNEY CLINIC ASSOCIATION NPI is 1700100104. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

128 N ELLIS ST
NEW BOSTON, TX
ZIP 75570-904
Phone: (903) 628-1104
Fax: (903) 628-0104

The provider's authorized official is Mary E Dwight .
The authorized official title is Chief Operating Officer and has the following contact phone number (903) 614-3282.

The CLIA number assigned to this NPI record is 45D0938567 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/15/2010 and was last updated on 2/24/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.