MEDICARE: MARK F. COLLINS M.D.

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	208600000X	Surgery Physician	G6709	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P02531907	OTHER	TX	MEDICARE RAIL ROAD
2	010066226	OTHER	TX	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184641797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK F. COLLINS M.D.

Provider Business Mailing Address
First Line	:	1325 PENNSYLVANIA AVE
Second Line	:	STE 200
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2100
Country	:	US
Telephone Number	:	817-332-9957
Fax Number	:	817-336-3130

Provider Business Practice Location Address
First Line	:	1000 9TH AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3906
Country	:	US
Telephone Number	:	817-927-2329
Fax Number	:	817-924-0177

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	01/04/2021

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Directions to “ MARK F. COLLINS M.D.” Practice Location

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