Healthcare Provider Details

I. General information

NPI: 1427732023
Provider Name (Legal Business Name): MYRA T COLLINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 INTERSTATE 35 S STE 105
NEW BRAUNFELS TX
78130-7465
US

IV. Provider business mailing address

1601 W 40TH AVE STE 100
PINE BLUFF AR
71603-6069
US

V. Phone/Fax

Practice location:
  • Phone: 830-643-7900
  • Fax: 830-643-5130
Mailing address:
  • Phone: 870-541-6010
  • Fax: 870-541-6009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberW7985
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE20115
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: