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NPI Code Detail

MEDICARE: MRS. HARLEY COLLIER PA-C

MEDICARE: MRS. HARLEY COLLIER PA-C
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
1363A00000XPhysician Assistant5064TN
2363A00000XPhysician AssistantPA16953TX

General Provider Information

NPI Number : 1588313035
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HARLEY COLLIER PA-C
Provider Business Mailing Address
First Line : 173 E BONDS RANCH RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76131-2631
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 173 E BONDS RANCH RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76131-2631
Country : US
Telephone Number : 682-212-9166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2022
Last Update Date : 01/07/2026

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Directions to “ MRS. HARLEY COLLIER PA-C” Practice Location

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