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General NPI Number Information
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NPI Number | 1043458672
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Entity Type | Organization
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Legal Business Name | W EDWARD COLLINS MD PA
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 3070 COLLEGE ST STE 208
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City | BEAUMONT
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State | TX
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Zip | 77701-4688
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Country | US
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Telephone | 409-835-1333
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Fax | 409-835-2629
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Provider Business Mailing Address
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Address Line | 3070 COLLEGE ST STE 208
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City | BEAUMONT
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State | TX
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Zip | 77701-4688
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Country | US
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Telephone | 409-835-1333
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Fax | 409-838-1326
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Authorized Official
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Title or Position | OWNER
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Name | DR. WELDON EDWARD COLLINS
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Credential | MD
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Telephone | 409-835-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | F9316
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License Number State | TX
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