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General NPI Number Information
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NPI Number | 1245580752
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Entity Type | Individual
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Provider Name | ASHLEY COLLAZO
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Gender | Female
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 7001 BOULEVARD 26 STE 501
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-8858
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Country | US
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Telephone | 972-814-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 3540 E CHENEY
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City | CELINA
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State | TX
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Zip | 75009-1682
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1219078
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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