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General NPI Number Information
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NPI Number | 1679418263
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Entity Type | Individual
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Provider Name | DEMERTRIA SHONDRAYA COLLINS
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Gender | Female
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 1620 GRANTLAND CIRCLE
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City | FT. WORTH
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State | TX
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Zip | 76112
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Country | US
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Telephone | 469-799-6199
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Fax |
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Provider Business Mailing Address
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Address Line | 10032 PYRITE DR
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City | FT WORTH
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State | TX
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Zip | 76131-4345
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Country | US
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Telephone | 469-799-6199
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Fax | 425-569-2236
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 1683241
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | 1683241
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License Number State | TX
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