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General NPI Number Information
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NPI Number | 1104074137
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Entity Type | Organization
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Legal Business Name | DARRYL DEWITT COLLINS, M.D.,P.A.
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 213 CEDAR DR SUITE A
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City | PORTLAND
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State | TX
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Zip | 78374-2921
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Country | US
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Telephone | 361-777-2886
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Fax | 361-777-3667
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Provider Business Mailing Address
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Address Line | 213 CEDAR DR SUITE A
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City | PORTLAND
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State | TX
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Zip | 78374-2921
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Country | US
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Telephone | 361-777-2886
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Fax | 361-777-3667
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. DARRYL DEWITT COLLINS
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Credential | M.D.
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Telephone | 361-777-2886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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