MEDICARE: AMARIEE S COLLINS CPM, LM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	7601000130	MI
2	2471S1302X	Sonography Radiologic Technologist	244398
3	2471V0105X	Vascular Sonography Radiologic Technologist	244398
4	176B00000X	Midwife	23100337

General Provider Information

NPI Number	:	1144096819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMARIEE S COLLINS CPM, LM

Provider Business Mailing Address
First Line	:	1914 ACACIAWOOD WAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-0006
Country	:	US
Telephone Number	:	832-630-4554
Fax Number	:

Provider Business Practice Location Address
First Line	:	1914 ACACIAWOOD WAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-0006
Country	:	US
Telephone Number	:	832-630-4554
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2023
Last Update Date	:	12/04/2023

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